ACEI联合醛固酮受体拮抗剂对高血压肾病患者Cys-C及尿微量蛋白的调节作用

唐焕君

doi:10.3969/j.issn.1006-0111.2018.02.008

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ACEI联合醛固酮受体拮抗剂对高血压肾病患者Cys-C及尿微量蛋白的调节作用

唐焕君

文章导航 > 药学实践与服务 > 2018 > 36(2): 131-135

唐焕君. ACEI联合醛固酮受体拮抗剂对高血压肾病患者Cys-C及尿微量蛋白的调节作用[J]. 药学实践与服务, 2018, 36(2): 131-135. doi: 10.3969/j.issn.1006-0111.2018.02.008

引用本文:

唐焕君. ACEI联合醛固酮受体拮抗剂对高血压肾病患者Cys-C及尿微量蛋白的调节作用[J]. 药学实践与服务, 2018, 36(2): 131-135. doi: 10.3969/j.issn.1006-0111.2018.02.008

TANG Huanjun. Effects of combination therapy with ACEI and aldosterone receptor antagonist on Cys-C and urinary microprotein in patients with hypertensive nephropathy[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(2): 131-135. doi: 10.3969/j.issn.1006-0111.2018.02.008

Citation:

TANG Huanjun. Effects of combination therapy with ACEI and aldosterone receptor antagonist on Cys-C and urinary microprotein in patients with hypertensive nephropathy[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(2): 131-135. doi: 10.3969/j.issn.1006-0111.2018.02.008

ACEI联合醛固酮受体拮抗剂对高血压肾病患者Cys-C及尿微量蛋白的调节作用

doi: 10.3969/j.issn.1006-0111.2018.02.008

唐焕君

四川绵阳404医院, 四川绵阳 621000

基金项目: 国家自然科学基金（81101797）

Effects of combination therapy with ACEI and aldosterone receptor antagonist on Cys-C and urinary microprotein in patients with hypertensive nephropathy

TANG Huanjun

Sichuan Mianyang 404 Hospital, Mianyang 621000, China

摘要: 目的探讨血管紧张素转化酶抑制剂（ACEI）联合醛固酮受体拮抗剂对高血压肾病患者血清半胱氨酸蛋白酶抑制剂C（Cys-C）及尿微量蛋白的调节作用。方法将患者随机分为两组，两组均给予盐酸贝那普利，试验组在ACEI的基础上给予螺内酯治疗。治疗后检测两组血压、肾功能、24 h尿蛋白、Cys-C、肾小球滤过率（GFR）、尿微量蛋白，及GFR与Cys-C及尿微量蛋白的相关性。结果经治疗，两组患者血压差异无统计学意义（P>0.05）；试验组肾功能明显优于对照组，24 h蛋白尿低于对照组（P<0.05）；试验组GFR水平明显高于对照组，Cys-C与尿微量蛋白明显低于对照组（P<0.05）；GFR与Cys-C及尿微量蛋白呈负相关。结论 ACEI联合醛固酮受体拮抗剂可以改善患者肾功能，减少24 h血尿，治疗后伴随着Cys-C及尿微量蛋白的降低，GFR的滤过能力明显提升。
- 血管紧张素转化酶抑制剂 /
- 醛固酮受体拮抗剂 /
- 高血压肾病 /
- 血清半胱氨酸蛋白酶抑制剂C /
- 尿微量蛋白
Abstract: Objective To investigate the effects of combination therapy with ACEI and aldosterone receptor antagonist on Cys-C and urinary microprotein regulation. Methods Patients were randomly divided into two groups. The control group received benazepine hydrochloride only. The experimental group received benazepine and spironolactone treatment. The blood pressure, renal function, 24 h urinary protein, Cys-C, GFR, urinary microprotein and the correlation of GFR with Cys-C and urinary microprotein were recorded. Results There was no statistically significant difference between two groups in blood pressure (P>0.05). After treatment, the renal function of the experimental group was significantly improved compared to that of the control group. The 24 h urine protein, Cys-C and urinary microprotein were significantly lower in the experimental group than the control group (P<0.05). GFR was negatively correlated with Cys-C and urinary microprotein. Conclusion The combination therapy of ACEI and aldosterone receptor antagonist can improve renal function and reduce 24 h hematuria. GFR filtration ability was significantly improved with the reduction of Cys-C and urinary microprotein.
- aldosterone receptor antagonist /
- hypertensive nephropathy /
- Cys-C /
- urinary microprotein /

[1]	Song KK, Zhao DL, Wang YD, et al. Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients:A Multicenter Study in China[J]. 中华医学杂志(英文版), 2017, 130(8):885-891.
[2]	Blacher J, Levy BI, Mourad JJ, et al. From epidemiological transition to modern cardiovascular epidemiology:hypertension in the 21st century[J]. Lancet, 2016, 388(10043):530-532.
[3]	中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华心血管病杂志, 2011, 39(7):579-616.
[4]	胡昭. 慢性肾脏病高血压及抗高血压药物临床实践指南[C].中华医学会肾脏病学分会2006年学术年会专题讲座,2006:148-155.
[5]	Hallan SI,Ritz E,Lydersen S, et al. Combining GFR and albuminuria to classify CKD improves prediction of ESRD[J]. J Am Soc Nephrol, 2009, 20(5):1069-1077.
[6]	全中, 郭志勇. 高血压肾病的研究现状[J]. 中国医药导报, 2012, 9(33):32-33.
[7]	James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults:Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)[J]. Jama, 2014, 311(5):507-520.
[8]	De Nicola L, Provenzano M, Chiodini P, et al. Independent Role of Underlying Kidney Disease on Renal Prognosis of Patients with Chronic Kidney Disease under Nephrology Care[J]. PloS ONE, 2015, 10(5):e0127071.
[9]	Shen JI, Saxena AB, Vangala S, et al. Renin-angiotensin system blockers and residual kidney function loss in patients initiating peritoneal dialysis:an observational cohort study[J]. BMC Nephrol, 2017, 18(1):196.
[10]	Ma TK, Kam K, Yan BP, et al. Renin-angiotensin-aldosterone system blockade for cardiovascular diseases:current status[J]. Br J Pharmacol, 2010, 160(6):1273-1292.
[11]	Kobayashi M, Hirooka K, Ono A, et al. The Relationship Between the Renin-Angiotensin-Aldosterone System and NMDA Receptor-Mediated Signal and the Prevention of Retinal Ganglion Cell Death[J]. Invest Ophthalmol Vis Sci, 2017, 58(3):1397-1403.
[12]	Liu L, Xu B, Ju Y. Addition of spironolactone in patients with resistant hypertension:A meta-analysis of randomized controlled trials[J]. Clin Exp Hypertens, 2017, 39(3):257-263.
[13]	Ching KC, Cohen DL, Fraker DL, et al. Adrenal vein sampling for primary aldosteronism:a 2-week protocol for withdrawal of renin-stimulating antihypertensives[J]. Cardiovascular & Interventional Radiology, 2016, 27(3):1-5.
[14]	Kim JS, Kim MK, Lee JY, et al. The effects of proteinuria on urinary cystatin-C and glomerular filtration rate calculated by serum cystatin-C[J]. Ren Fail, 2012, 34(6):676-684.
[15]	陈冬莲, 郑身宏, 刘首明,等. Cys-C、HbA1c、GA和U-mAlb/Cr检测对2型糖尿病早期肾损伤的诊断价值[J]. 国际检验医学杂志, 2014,35(6):677-679.
[16]	刘建. 重视微量白蛋白尿的筛查-早期发现慢性肾脏病[C].中华医学会肾脏病学分会2006年学术年会专题讲座,2006:156-167.
[17]	Svenningsen P, Andersen H, Nielsen LH, et al. Urinary serine proteases and activation of ENaC in kidney-implications for physiological renal salt handling and hypertensive disorders with albuminuria[J]. Pflügers Archiv:Eur J Physiol, 2015, 467(3):531-542.

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ACEI联合醛固酮受体拮抗剂对高血压肾病患者Cys-C及尿微量蛋白的调节作用

doi: 10.3969/j.issn.1006-0111.2018.02.008

唐焕君

四川绵阳404医院, 四川绵阳 621000

基金项目: 国家自然科学基金（81101797）

收稿日期: 2017-11-05
修回日期: 2017-12-25

关键词:

摘要: 目的探讨血管紧张素转化酶抑制剂（ACEI）联合醛固酮受体拮抗剂对高血压肾病患者血清半胱氨酸蛋白酶抑制剂C（Cys-C）及尿微量蛋白的调节作用。方法将患者随机分为两组，两组均给予盐酸贝那普利，试验组在ACEI的基础上给予螺内酯治疗。治疗后检测两组血压、肾功能、24 h尿蛋白、Cys-C、肾小球滤过率（GFR）、尿微量蛋白，及GFR与Cys-C及尿微量蛋白的相关性。结果经治疗，两组患者血压差异无统计学意义（P>0.05）；试验组肾功能明显优于对照组，24 h蛋白尿低于对照组（P<0.05）；试验组GFR水平明显高于对照组，Cys-C与尿微量蛋白明显低于对照组（P<0.05）；GFR与Cys-C及尿微量蛋白呈负相关。结论 ACEI联合醛固酮受体拮抗剂可以改善患者肾功能，减少24 h血尿，治疗后伴随着Cys-C及尿微量蛋白的降低，GFR的滤过能力明显提升。