高剂量缬沙坦对老年糖尿病肾病伴高血压患者血压、左心功能及血管内皮功能的影响  

Effects of High-dose Valsartan on Blood Pressure Control,Left Ventricular Function and Vascular Endothelial Function in Elderly Patients with Diabetic Kidney Disease and Hypertension

作　　者：石薪[1] 李广银[1] 庞玉洪[2] 谷明军[3] 成艳[4] SHI Xin;LI Guang-yin;PANG Yu-hong;GU Ming-jun;CHENG Yan(Pharmaceutical Department,Chongqing Fuling Central Hospital,Chongqing 408000,China;Department of Nephrology,Chongqing Fuling Central Hospital,Chongqing 408000,China;Department of Endocrinology,Chongqing Fuling Central Hospital,Chongqing 408000,China;Department of General Medicine,Chongqing Fuling Central Hospital,Chongqing 408000,China)

机构地区：[1]重庆市涪陵中心医院药学部,重庆市408000 [2]重庆市涪陵中心医院肾内科,重庆市408000 [3]重庆市涪陵中心医院内分泌科,重庆市408000 [4]重庆市涪陵中心医院全科医学科,重庆市408000

出　　处：《中国分子心脏病学杂志》2021年第1期3707-3710,共4页Molecular Cardiology of China

基　　金：重庆市卫生和计划生育委员会医学科研计划基金资助项目(20172179)。

摘　　要：目的探究高剂量缬沙坦对老年糖尿病肾病(DKD)伴高血压患者血压控制、左心功能及血管内皮功能的影响。方法选取2017年3月至2020年7月收治的DKD伴高血压患者150例,随机数表法分为高剂量组和低剂量组,每组各75例。两组患者均接受常规对症治疗,在此基础上,高剂量组接受160 mg/d的缬沙坦治疗,低剂量组接受80 mg/d的缬沙坦治疗。比较两组患者治疗前后血压、左心功能和血清凝血酶调节蛋白(TM)、凝血因子Ⅷ(vWF)水平变化,观察治疗后不良反应发生情况。结果治疗后,高剂量组患者的收缩压(SBP)、舒张压(DBP)、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)明显低于低剂量组,左室射血分数(LVEF)明显高于低剂量组(P<0.05);治疗后,高剂量组患者的血清TM、vWF水平明显低于低剂量组(P<0.05);两组患者的不良反应发生率比较无明显差异(P>0.05)。结论高剂量缬沙坦在控制DKD伴高血压患者血压方面具有良好疗效,并改善心功能,降低血清TM、vWF水平。Objective To investigate the effects of high-dose valsartan on blood pressure control,left ventricular function and vascular endothelial function in elderly patients with diabetic kidney disease(DKD)complicated with hypertension.Methods Between March 2017 and July 2020,150 patients with DKD and hypertension were selected and randomly divided into low-dose group and high-dose group(n=75).Both groups were given conventional symptomatic treatment.Moreover,the high-dose group was treated with 160 mg/d of valsartan,while the low-dose group was treated with 80 mg/d of valsartan.Changes in blood pressure,left ventricular function,serum thrombomodulin(TM)and von Willebrand factor(vWF)levels before and after treatment were compared between the two groups.Meanwhile,adverse reactions were observed.Results After treatment,the high-dose group had significantly lower systolic blood pressure(SBP),diastolic blood pressure(DBP),left ventricular end-systolic diameter(LVESD),and left ventricular end-diastolic diameter(LVEDD),and significantly higher left ventricular ejection fraction(LVEF)than the low-dose group(P<0.05).After treatment,serum TM and vWF levels in the high-dose group were significantly lower than those in the low-dose group(P<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion High-dose valsartan is effective in controlling blood pressure of patients with DKD and hypertension,which can improve cardiac function,and reduce serum TM and vWF levels.

关 键 词：糖尿病肾脏疾病 高血压 缬沙坦 心功能 血管内皮损伤 

分 类 号：R544.1[医药卫生—心血管疾病] R587.2[医药卫生—内科学] R692.9[医药卫生—临床医学]