Objective To explore the curative effect of valsartan combined with alprostadil in the treatment of chronic glomerulonephritis (CGN) and the influence on patients with renal function, hemorrheology, serum tissue plas-minogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1). Methods Eighty patients with CGN from January 2015 to December 2016 in our hospital were divided into as observation group (n=40) and control group (n=40) in terms of different treatment methods. The observation group was treated with valsartan combined with alprostadil, and the con-trol group with valsartan only. Each group was treated with two courses in succession, each of which was four weeks. The clinical efficacy was evaluated, and the renal function, hemorrheology, t-PA, PAI-1 were measured and com-pared between the two groups before and after treatment. Results The total effective rate of the observation group was 92.5％, significantly higher than that of the control group (75.0％), P<0.05. After treatment, the levels of urine protein (Upro), serum creatinine (SCr), blood urea nitrogen (BUN), urine red blood cell count were (1.02 ± 0.36) g/24 h, (135.45 ± 31.45) μmol/L, (10.72 ± 2.98) mmol/L, (135.45 ± 31.45)/HP respectively in the observation group, which were significantly lower than the corresponding (1.45 ± 0.34) g/24 h, (168.76 ± 29.46)μmol/L, (12.12 ± 3.12) mmol/L, (26.92 ± 9.59)/HP respectively in the control group, and the levels of above in the two groups were all significantly lower than those before treatment (P<0.05 or P<0.01). After treatment, the levels of the whole blood high shear viscosity, whole blood low shear viscosity, t-PA, PAI-1 were (3.23±1.27) mPa·s, (7.51±1.55)μmol/L, (5.64±1.07)μmol/L, (27.65±4.60)μmol/L respectively in the observation group, which were significantly lower than the corresponding (3.98±1.41) mPa·s, (8.47±1.62)μmol/L, (4.43±1.02)μmol/L, (38.74±5.06)μmol/L respectively in the control group, and the levels of above in the two groups were all significantly lower than those before treatment excepted that t-PA was significantly higher than that before treatment (P<0.05 or P<0.01). Conclusion It was remarkable to relieve renal function effectively, im-prove blood flow velocity, balance serum t-PA and PAI-1 levels in the treatment of CGN with valsartan combined with alprostadil.%目的 探究缬沙坦联合前列地尔治疗慢性肾小球肾炎(CGN)的临床疗效及对患者肾功能、血流变学指标、血清组织型纤溶酶原激活物(t-PA)、纤维蛋白溶解酶原激活物抑制剂-1(PAI-1)的影响.方法 选取东海县人民医院2015年1月至2016年12月收治的80例CGN患者,并依据治疗方式的不同分为观察组(n=40)和对照组(n=40).观察组采取缬沙坦联合前列地尔疗法,对照组仅给予缬沙坦治疗.两组均以4周为一个疗程,且连续治疗两个疗程.评价两组患者临床疗效,测定并比较两组患者治疗前后肾功能、血流变学及t-PA、PAI-1等水平.结果 观察组患者的治疗总有效率为92.5％,明显高于对照组的75.0％,差异有统计学意义(P<0.05);治疗后,观察组患者的尿蛋白量(Upro)水平为(1.02±0.36)g/24 h,血肌酐(SCr)水平为(135.45±31.45)μmol/L,尿素氮(BUN)水平为(10.72±2.98)mmol/L,尿红细胞计数为(16.34±6.98)个/HP,对照组分别为(1.45±0.34)g/24 h、(168.76±29.46)μmol/L、(12.12±3.12)mmol/L、(26.92±9.59)个/HP,均较治疗前显著下降,且观察组显著低于对照组,差异均有统计学意义(P<0.05或P<0.01);治疗后,观察组患者的全血高切黏度为(3.23±1.27)mPa·s,全血低切黏度为(7.51±1.55)mPa·s,t-PA水平为(5.64±1.07)μmol/L,PAI-1水平为(27.65±4.60)μmol/L,对照组分别为(3.98±1.41)mPa·s、(8.47±1.62)mPa·s、(4.43±1.02)μmol/L、(38.74±5.06)μmol/L,两组均较治疗前显著下降,t-PA水平较治疗前显著升高,且组间比较差异均有统计学意义(P<0.05或P<0.01).结论 缬沙坦与前列地尔联用治疗CGN,可有效缓解患者肾功能状态,改善其血流速度,平衡机体血清t-PA和PAI-1水平,效果显著.
展开▼
