探讨不同剂量缬沙坦治疗慢性肾小球肾炎合并高血压的临床疗效

摘要

Objective To explore clinical curative effect of different doses of valsartan in treatment of chronic glomerulonephritis combined with hypertension.Methods94 patients with chronic glomerulonephritis who were admittedin our hospital from January 2014 to January 2015 were selected as research objects.They were allocated to the routine group and the high dose group according to random number table method,with 47 cases in each. Patients in the routine group were treated with oral valsartan 160mg/D while patients in the high dose group were treated with oral valsartan 320mg/d.Patients in two groups were both treated for 6 months.Indexes including blood pressure, serum creatinine (SCR),glomerular filtration rate (GFR),24h urinary protein before and after treatment were collected.ResultsBasic data including age,gender,course of disease and so on patients in two groups showed no significant difference(P>0.05).SCR,GFR,24h urinary protein before treatment of patients in the two groups also showed no significant difference(P>0.05).After treatment,SCR,GFR and 24h urinary protein of patients in two groups were all significantly improved but the improving effect of the high dose group was more significant.The difference had statistical significance (P<0.05).Total effective rate and incidence of adverse reactions of the routine group and the high dose treatment group had no significant difference (P>0.05),which had no statistical significance.ConclusionHigh dose of valsartan in the treatment of chronic glomerulonephritis combined with hypertension can delay renal failure and reduce the occurrence and development of proteinuria.In addition, it is safe and of low incidence of adverse reactions which is worthy of clinical application and promotion.%目的：探讨不同剂量缬沙坦治疗慢性肾小球肾炎合并高血压的临床疗效。方法选取2014年1月～2015年1月我院收治的慢性肾小球肾炎患者94例，作为研究对象。采用随机数表法将其分为常规组与高剂量组，每组患者47例，其中常规组患者口服缬沙坦160mg/d，高剂量组口服缬沙坦320mg/d，两组患者共治疗6个月，采集治疗前后血压、血清肌酐（Scr）、肾小球滤过率（GFR）、24h尿蛋白等指标的变化情况。结果两组患者年龄、性别、病程等基础资料比较无显著差异（P＞0.05），两组患者治疗前Scr、GFR、24h尿蛋白比较无显著差异（P＞0.05），两组患者治疗后Scr、GFR、24h蛋白尿均有所改善，但高剂量组改善效果更显著，具有统计学意义（P＜0.05）；常规组与高剂量组治疗总有效率及不良反应发生率比较无统计学意义（P＞0.05）。结论高剂量缬沙坦治疗慢性肾小球肾炎合并高血压具有延缓肾功能衰竭、降低蛋白尿发生发展的作用，并且应用较为安全，不良反应发生率较低，具有临床应用及推广价值。