贝前列素钠联合缬沙坦治疗高血压早期肾损伤患者疗效及其对肾功能、凝血功能的影响

摘要

目的 观察贝前列素钠联合缬沙坦治疗高血压早期肾损伤(CKD1-3期)患者的疗效及对肾功能、凝血功能的影响.方法 选择2015年8月-2017年8月常熟市第一人民医院肾内科治疗的高血压肾损伤(CKD1-3期)患者94例作为研究对象,按照随机数字表法分为2组,每组47例.对照组给予缬沙坦治疗,观察组给予贝前列素钠联合缬沙坦治疗.治疗2个月,对比2组临床疗效、治疗前后肾功能水平、凝血功能水平变化及不良反应.结果 观察组治疗总有效率为97.87％,高于对照组的78.72％(x2=8.340,P=0.004);治疗后,观察组尿蛋白肌酐比(UACR)、尿N-乙酰-β-C氨基葡萄糖肝酶(NAG)、α1-微球蛋白(α1-MG)、胱抑素(CysC)和β2-微球蛋白(β32-MG)水平均高于对照组(t=17.853、18.842、14.648、15.485、12.670,P均=0.000),纤维蛋白原(Fib)、D-二聚体(D-D)、血小板平均容积(MPV)水平低于对照组,抗凝血酶Ⅲ(ATⅢ)水平高于对照组,差异均有统计学意义(t=7.858、5.836、3.689、3.743,P均=0.000).观察组治疗2个月后不良反应发生率与对照组比较,差异无统计学意义(8.51％ vs.10.64％,x2=0.123,P=0.726).结论 贝前列素钠联合缬沙坦治疗高血压肾损伤(CKD1-3期)患者可明显提高临床疗效,改善患者肾功能和凝血功能,值得临床推广.%Objective To investigate the effects of beraprost sodium combined with valsartan in the treatment of patients with hypertensive renal injury (CKD1-3) and its effect on renal function and coagulation function.Methods A total of 94 patients with hypertensive renal injury (CKD1-3) treated in department of nephrology,Changshu Hospital Affiliated to Soochow University from August 2015 to August 2017 were selected as the study subjects.According to the random number table,patients were divided into 2 groups,with 47 cases in each group.The control group was treated with valsartan and the observation group was treated with beraprost sodium and valsartan.The clinical efficacy,the level of renal function before and after treatment,the changes of coagulation function and adverse reactions were compared between the two groups.Results The total effective rate of observation group was higher than that of control group (97.87％ vs.78.72％,x2 =-8.340,P =0.004).After treatment,the levels of UACR,NAG,α1-MG,CysC and β2-MG in the observation group were higher than those in the control group (t =17.853,18.842,14.648,15.485,12.670,P =0.000).The level of AT Ⅲ in the control group was higher than that in the control group (t =7.858,5.836,3.689,3.743,P =0.000).The incidence of adverse reactions in the observation group after 2 months of treatment was not significantly different from that in the control group (8.51％ vs.10.64％,x2 =0.123,P =0.726).Conclusion Bebeprost sodium combined with valsartan in patients with hypertension and early renal injury can significantly improve clinical efficacy and improve renal function and coagulation function,which worthy of clinical promotion.