中国临床药理学杂志2024，Vol.40Issue(8)：1091-1095,5.DOI:10.13699/j.cnki.1001-6821.2024.08.001
螺内酯联合沙库巴曲缬沙坦治疗高血压肾病患者的临床研究
Clinical trial of spironolactone combined with sacubitril/valsartan in the treatment of patients with hypertensive nephropathy
王琳琳 1冯佳莉 1刘圣君 1乔振华 1贾秀玲 1韩小丽1
作者信息
- 1. 河北北方学院附属第一医院肾脏内科,河北张家口 075000
- 折叠
摘要
Abstract
Objective To observe the clinical efficacy and safety of spironolactone combined with sacubitril/valsartan in the treatment of patients with hypertensive nephropathy.Methods The patients with hypertensive nephropathy were randomly divided into control group and treatment group.The control group was treated with sacubitril/valsartan(100-200 mg·d-1 in the morning),and treatment group was combined with low-dose spironolactone treatment(20 mg·d-1 in the morning)on the basis of control group.Both groups were treated continuously for 12 weeks.The clinical efficacy was compared;the blood pressure,urinary microalbumin(mAlb),urinary β2 microglobulin(β2-MG)and serum cystatin C(Cys-C),transforming growth factor-β1(TGF-β1),connective tissue growth factor(CTGF)and angiotensin Ⅱ(Ang Ⅱ)and adverse drug reactions were observed before and after treatment.Results There were 87 cases in treatment group and 86 cases in control group were included respectively.After treatment,the total effective rates in treatment group and control group were 95.40％(83 cases/87 cases)and 82.56％(71 cases/86 cases),with significant difference(P＜0.05).After treatment,the systolic blood pressure values in treatment group and control group were(124.65±9.65)and(130.27±8.93)mmHg,the diastolic blood pressure values were(75.08±7.14)and(80.45±7.35)mmHg,urinary mAlb levels were(42.58±5.65)and(51.28±6.64)mg·L-1,urinary β2-MG levels were(0.46±0.17)and(0.75±0.25)mg·L-1,24 h urinary protein quantitation levels were(138.49±46.64)and(216.48±65.27)mg,serum Cys-C levels were(0.63±0.26)and(0.85±0.24)mg·L-1,TGF-β1 levels were(98.67±21.43)and(112.46±26.72)pg·mL-1,CTGF levels were(1 206.54±236.56)and(1 340.51±248.25)pg·mL-1,Ang Ⅱ levels were(101.55±17.62)and(115.65±20.08)pg·mL-1,all with significant difference(all P＜0.05).The incidence of adverse drug reactions in treatment group and control group were 6.90％(6 cases/87 cases)and 2.33％(2 cases/86 cases),with no significant difference(P＞0.05).Conclusion Compared with sacubitril/valsartan alone,spironolactone combined with sacubitril/valsartan can better reduce blood pressure,improve renal function and delay progression of renal fibrosis in the treatment of hypertensive nephropathy,and has definite efficacy,with good safety.关键词
螺内酯/沙库巴曲缬沙坦/高血压肾病/肾功能Key words
spironolactone/sacubitril/valsartan/hypertensive nephropathy/renal function分类
医药卫生引用本文复制引用
王琳琳,冯佳莉,刘圣君,乔振华,贾秀玲,韩小丽..螺内酯联合沙库巴曲缬沙坦治疗高血压肾病患者的临床研究[J].中国临床药理学杂志,2024,40(8):1091-1095,5.
