螺内酯联合缬沙坦对高血压早期肾损害患者尿微量白蛋白及肾功能的影响  

Effects of spironolactone combined with valsartan on microalbuminuria and renal function in patients with early renal damage caused by hypertension

作　　者：管红斌[1] 何凯平[2] 桓文穆 Guan Hongbin;He Kaiping;Huan Wenmu(Department of Nephrology, First Hospital, Guangdong Univeristy of Pharmacy, Guangzhou 510080, China;Statistics Room of Medical Records, First Hospital, Guangdong Univeristy of Pharmacy, Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院肾内科,广州510080 [2]广东药科大学附属第一医院病案统计科,广州510080

出　　处：《国际医药卫生导报》2019年第9期1420-1423,共4页International Medicine and Health Guidance News

摘　　要：目的探讨螺内酯联合缬沙坦治疗高血压早期肾损害患者的临床疗效及用药安全性。方法均采用随机对照的方法将60例高血压早期肾损害患者随机分为对照组和治疗组。对照组晨服缬沙坦,80mg/d,2周内缬沙坦用量增加至160mg/d。治疗组在对照组治疗基础上加服小剂量螺内酯,20mg/d,连续治疗12周。治疗前后,测定尿微量白蛋白(MAU)、尿β2-微球蛋白(β2-MG)、血清胱抑素(CysC)、血清钾(K)。结果治疗后,治疗组MAU、β2-MG、CysC水平明显低于对照组[(38.52±3.65)mg/L比(69.86±4.65)mg/L、(2.33±0.19)mg/L比(4.93±0.26)mg/L、(0.62±0.01)mg/L比(0.86±0.03)mg/L],差异均有统计学意义(均P<0.05);两组治疗后血清K差异无统计学意义[(4.11±0.42)mmol/L比(3.93±0.52)mmol/L,P>0.05]。结论缬沙坦联合螺内酯治疗高血压早期肾损害患者可降低MAU、β2-MG水平,改善肾功能。Objective To explore the clinical efficacy and safety of an spironolactone combined with valsartan in the treatment of patients with early renal damage caused by hypertension. Methods Sixty patients with early renal damage caused by hypertension were randomly divided into a control group and a treatment group. The control group took valsartan 80 mg/d in the morning, and the dosage was increased to 160 mg/d within 2 weeks;in addition, the treatment group took spironolactone 20 mg/d for 12 weeks. The microalbuminuria (MAU), urine beta2-microglobulin (β2-MG), serum cystatin C (CysC), serum potassium(K) were determined before and after the treatment. Results After the treatment, the levels of MAU,β2-MG, and CysC were significantly lower in the treatment group than in the control group [(38.52±3.65) mg/L vs.(69.86±0.65) mg/L,(2.33±0.19) mg/L vs.(4.93±0.26) mg/L, and (0.62±0.01) mg/L vs.(0.86±0.03) mg/L;all P < 0.05]. The level of K was (4.11±0.42) mmol/L in the treatment group and was (3.93±0.52) mmol/L in the control group (P > 0.05). Conclusion Spironolactone combined with valsartan for patients with early renal damage caused by hypertension can lower the levels of MAU and β2-MG, and improve the renal function.

关 键 词：螺内酯 缬沙坦 高血压病 尿微量白蛋白 尿Β2-微球蛋白 血清胱抑素 

分 类 号：R544.1[医药卫生—心血管疾病]