前列地尔联合依那普利叶酸治疗高血压肾病患者的临床研究  

Clinical trial of alprostadil combined with enalapril folic acid in the treatment of patients with hypertensive nephropathy

作　　者：张磊[1] 曹微[1] 田加坤 张娜[1] ZHANG Lei;CAO Wei;TIAN Jia-kun;ZHANG Na(Department of Nephrology,Lianyungang First People's Hospital,Lianyungang 222000,Jiangsu Province,China)

机构地区：[1]连云港市第一人民医院肾内科,江苏连云港222000

出　　处：《中国临床药理学杂志》2020年第18期2752-2755,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察前列地尔与依那普利叶酸对高血压肾病患者血流动力学和动脉弹性的影响。方法将132例高血压肾病患者随机分成对照组和试验组,每组各66例。对照组给予常规治疗联合前列地尔10μg,每天1次,静脉滴注;试验组在对照组的基础上给予依那普利叶酸,每次5 mg,每天2次,口服。2组均连续治疗30 d。比较2组肾血流动力学、动脉弹性、肾功能、肾实质纤维化指标的变化及治疗期间药物不良反应发生情况。结果治疗后,对照组和试验组肾动脉阻力指数(RI)分别为0.58±0.08,0.46±0.06;搏动指数(PI)分别为1.21±0.17,1.02±0.11;血管超负荷指数(VOI)分别为17.38±1.71,10.07±1.21;24 h尿蛋白分别为(2.13±0.22),(1.63±0.15)g,血清尿素氮(BUN)分别为(8.59±1.61),(6.13±1.32)mmol·L^-1;血肌酸酐(Scr)分别为(58.37±6.91),(51.23±5.62)μmol·L^-1;Ⅳ型胶原蛋白(ColⅣ)分别为(112.37±12.61),(89.37±9.21)ng·mL^-1;层粘连蛋白(LN)分别为(141.26±15.39),(108.59±11.62)μg·L^-1;Ⅲ型前胶原肽(PⅢP)分别为(15.39±2.68),(8.96±1.31)ng·L^-1,差异均有统计学意义(均P<0.05)。对照组和试验组的药物不良反应发生率分别为16.67%,21.21%,差异无统计学意义(P>0.05)。结论前列地尔联合依那普利叶酸能有效改善肝肾高血压肾病患者的肾血流动力学,提高血管弹性,减缓或逆转肾实质纤维化进程,促进肾功能恢复,且安全性好。Objective To expolre the effect of alprostadil and enalapril folic acid on hemodynamics and arterial elasticity in patients with hypertensive nephropathy.Methods A total of 132 patients with hypertensive nephropathy were randomly divided into control group and treatment group,66 patients in each group.Control group was treated with conventional therapy combined with alprostadil 10μg·times^-1,qd,iv,treatment group was treated with enalapril folic acid 5 mg·time-1,bid,oral,on the basis of control group.Both groups were treated for 30 d.Changes in the renal hemodynamics,arterial elasticity,renal function and renal parenchymal fibrosis and the adverse drug reactions were compared between the two groups.Results After treatment,the renal artery resistance index(RI)in control group and treatment group were 0.58±0.08,0.46±0.06,pulsatile index(PI)were 1.21±0.17,1.02±0.11,vascular overload index(VOI)were 17.38±1.71,10.07±1.21,the 24 h urine protein were(2.13±0.22),(1.63±0.15)g,urea nitrogen(BUN)were(8.59±1.61),(6.13±1.32)mmol·L^-1,serum creatinine(Scr)were(58.37±6.91),(51.23±5.62)μmol·L^-1,the typeⅣcollagen(ColⅣ)were(112.37±12.61),(89.37±9.21)ng·mL^-1,laminin(LN)were(141.26±15.39),(108.59±11.62)μg·L^-1,typeⅢprocollagen peptide(PⅢP)were(15.39±2.68),(8.96±1.31)ng·L^-1,all with siginificant difference(all P<0.05).The incidence of adverse drug reactions in control group and treatment group were 16.67%,21.21%,with no significant difference(P>0.05).Conclusion Alprostadil combined with enalapril folate can effectively improve renal hemodynamics and arterial elasticity,slow or reverse the process of renal parenchymal fibrosis and promote renal function recovery in patients with hepatorenal hypertension and nephropathy,with good safety.

关 键 词：高血压肾病 前列地尔 依那普利叶酸 肾血流动力学 动脉弹性 肾功能 

分 类 号：R97[医药卫生—药品]