血管紧张素受体阻断剂对慢性肾病患者尿蛋白、脂质代谢及炎症因子的影响
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安徽省首批学术技术带头人基金(2002HBL25)


Effects of Angiotensin Receptor Blockers on Proteinuria,Lipid Metabolism and Inflammatory Factors in patient with Chronic Glomerular Disease
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    目的观察血管紧张素系统阻断剂对慢性肾脏疾病患者脂质代谢、血管紧张素Ⅱ、白细胞介素1及C反应蛋白水平的的影响。方法89例伴有蛋白尿的慢性肾小球疾病患者随机分为三组:苯那普利组(n=30)、缬沙坦组(n=30)和联合治疗(苯那普利+缬沙坦)组(n=29),治疗8~12周。分别检测血脂、血管紧张素Ⅱ、白细胞介素1和C反应蛋白水平及24 h尿蛋白定量。结果治疗后各组血清总胆固醇水平显著降低;联合治疗组甘油三酯水平显著降低(P<0.05);苯那普利组和联合治疗组对低密度脂蛋白、载脂蛋白B水平的影响大于缬沙坦组(P<0.01)。苯那普利组及联合治疗组血清血管紧张素Ⅱ水平均较治疗前显著降低(P<0.05),而缬沙坦组血清血管紧张素Ⅱ水平较治疗前上升(P<0.05)。血清白细胞介素1和C反应蛋白水平均较治疗前下降(P<0.05)。治疗后各组蛋白尿均降低(P<0.05),联合治疗治疗组降低蛋白尿疗效优于苯那普利组及缬沙坦组(P<0.05),苯那普利组与缬沙坦组之间差别无统计学意义。结论血管紧张素阻断剂可改善慢性肾脏疾病患者脂质代谢紊乱,下调血清血管紧张素Ⅱ、白细胞介素1及C反应蛋白的表达,降低尿蛋白,联合治疗用药疗效更佳。

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    Aim To investigate the effect of angiotensin system blockers on the levels of serum angiotensin Ⅱ(Ang Ⅱ),interleukin-1(IL-1),C-reaction protein(CRP) and lipid metabolism in patient with chronic glomerular disease. Methods 89 cases of chronic glomerular disease were randomly divided into 3 groups: benazepril group(n=30),valsartan group(n=30) and combination of benazepril and valsartan group(n=29).Serum Ang Ⅱ,IL-1,CRP,quantity of 24 hour urinary protein and lipid were measured before and after 8~12 weeks therapy. Results Serum total cholesterol were effectively decreased in 3 groups after therapy.Combination of benazepril and valsartan therapy reduced triglyceride effectively.Benazepril group and combination of benazepril and valsartan group have more influence on the low density lipoprotein(LDL),apolipoprotein B than valsartan group(P<0.01).Meanwhile the levels of serum Ang Ⅱwas effectively decreased in benazepril group and combination of benazepril and valsartan group(P<0.05),in contrast to valsartan group,the level of serum Ang Ⅱ was increased(P<0.05).The levels of serum IL-1 and CRP were significantly reduced after therapy(P<0.05).Therapeutic alliance group decreased proteinuria more effectively than that of benazepril alone or valsartan alone(P<0.05). Conclusions The combination of benazepril and valsartan may reduce the level of serum Ang Ⅱ,IL-1 and CRP,decrease urine protein excretion and ameliorate lipid metabolism in patients with chronic glomerular disease.

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杨沿浪,张道友,陈卫东,黄杨杨,李龙海,汪裕伟,朱新俭,徐海红,杨利才.血管紧张素受体阻断剂对慢性肾病患者尿蛋白、脂质代谢及炎症因子的影响[J].中国动脉硬化杂志,2008,16(6):476~478.

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  • 收稿日期:2007-12-25
  • 最后修改日期:2008-04-01
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