硝苯地平控释片联合沙库巴曲缬沙坦对2型糖尿病肾病合并高血压患者疗效及内皮功能的影响  

Therapeutic Effect of Nifedipine Controlled-release Tablets Combined with Sacubitril Valsartan on Patients with Type 2 Diabetic Nephropathy Complicated with Hypertension and Its Effect on Endothelial Function

作　　者：孔五宝 李华君 王晓蕴[1] 王元松[1] 孙云川[1] 董艳芳[1] 金倩倩 罗英[2] 牛跃龙 赵红敏 KONG Wu-bao;LI Hua-jun;WANG Xiao-yun;WANG Yuan-song;SUN Yun-chuan;DONG Yan-fang;JIN Qian-qian;LUO Ying;NIU Yue-long;ZHAO Hong-min(Department of Endocrinology,Cangzhou Hospital of Integrated Traditional Chinese and Western medicine,Cangzhou,Hebei 061001,China;Department of Nuclear Medicine,North China Petroleum Administration General Hospital,Cangzhou,Hebei 062550,China)

机构地区：[1]沧州中西医结合医院内分泌科,河北沧州061001 [2]华北石油管理局总医院核医学科,河北沧州062550

出　　处：《解放军医药杂志》2021年第2期51-55,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省医学科学研究重点课题计划项目(20191276)。

摘　　要：目的探讨硝苯地平控释片联合沙库巴曲缬沙坦对2型糖尿病肾病合并高血压患者疗效对内皮功能的影响。方法选取2018年1月—2019年1月我院收治的2型糖尿病肾病合并高血压100例为研究对象,按照治疗方法不同分为观察组和对照组,每组50例。观察组给予硝苯地平控释片联合沙库巴曲缬沙坦,对照组给予硝苯地平控释片联合缬沙坦。治疗前后对2组血压、尿素(BUN)、尿微量白蛋白(mALB)、血清炎性因子[胱抑素C(CysC)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、血栓调节蛋白(TM)、血管性血友病因子(vWF)、血管紧张素Ⅱ(AngⅡ)、转化生长因子β1(TGF-β1)、锌-α2-糖蛋白(ZAG)]及血糖相关指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)]进行检测及比较。结果2组治疗后收缩压、舒张压、FPG、HbA1c、TGF-β1、ZAG水平均显著降低,且观察组低于对照组(P<0.05)。2组治疗后CysC、BUN、hs-CRP、IL-6、mALB、AngⅡ、TM、vWF均显著降低,且观察组低于对照组(P<0.05)。2组不良反发生率比较差异无统计意义(P>0.05)。结论沙库巴曲缬沙坦联合硝苯地平控释片治疗2型糖尿病肾病合并高血压效果好,可有效缓解病情,减缓肾功能衰竭进程,且疗效优于硝苯地平控释片联合缬沙坦。Objective To investigate the effect of Nifedipine controlled-release tablets combined with sacubitril valsartan on type 2 diabetic nephropathy(DN)complicated with hypertension and its effect on endothelial function.Methods A total of 100 cases of type 2 DN complicated with hypertension in our hospital from January 2018 to January 2019 were selected as the research subjects.They were divided into observation group and control group according to different treatment methods,with 50 cases in each group.The observation group was given Nifedipine controlled-release tablets combined with sacubitril valsartan,while the control group was given Nifedipine controlled-release tablets combined with valsartan.Blood pressure,blood urea nitrogen(BUN),urinary microalbumin(mAlb),serum inflammatory factors[cystatin C(CysC),high-sensitivity C-reactive protein(hs-CRP),interleukin(IL)-6,thrombomodulin(TM),von Willebrand factor(vWF),AngiotensinⅡ(angⅡ),transforming growth factor-β1(TGF-β1),zinc-α2-glycoprotein(ZAG)]in both groups were measured before and after treatment.And blood glucose-related indicators[glycosylated hemoglobin(HbA1c),fasting blood glucose(FPG)]were detected and compared.Results After treatment,systolic blood pressure,diastolic blood pressure,FPG,HbAlc,TGF-β1 and ZAG levels in the two groups were significantly decreased,and the indicators were better in the observation group than in the control group(P<0.05).CysC,BUN,hs-CRP,IL-6,mALB,AngⅡ,TM,and vWF in both groups were significantly decreased,and the indicators were lower in the observation group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The effect of sacubitril valsartan combined with Nifedipine controlled-release tablets in the treatment of type 2 DN complicated with hypertension is good,which can effectively alleviate the condition and slow down the process of renal failure.The therapeutic effect is better than Nifedipine controlled-release tablets

关 键 词：糖尿病肾病 糖尿病 2型 高血压 沙库巴曲缬沙坦 血管紧张素Ⅱ 转化生长因子Β1 白介素-6 血栓调节蛋白 

分 类 号：R587.24[医药卫生—内分泌]