摘要
目的探讨不同剂量缬沙坦对糖尿病肾病血液透析患者血压和血压变异性的影响。方法患者来源于承德医学院附属医院血液透析室,诊断为糖尿病肾病(慢性肾衰竭尿毒症期),共54例,其中男性28例,女性26例,入选时间为2006年12月至2012年6月。征得患者同意后将患者分为缬沙坦80 mg晨起顿服治疗组(n=25)和160 mg晨起顿服治疗组(n=29),监测、对比、分析2组治疗前及治疗后12周24 h动态血压及各项相关实验室指标。结果治疗12周后2组患者血压、血压变异性和24 h尿蛋白定量水平较治疗前均明显降低(P<0.05),缬沙坦160 mg治疗组的夜间平均收缩压(night systolic blood pressure,nSBP)(124.76±7.64 vs 138.57±10.98)mmHg,夜间平均舒张压(night diastolic blood pressure,nDBP)(74.45±7.25 vs 79.86±7.08)mmHg,夜间收缩压标准差(night systolic blood pressure variability,nSBPV)(0.069 8±0.011 3 vs 0.074 6±0.012 5),夜间舒张压标准差(night diastolic blood pressure variability,nDBPV)(0.085 7±0.009 4 vs 0.095 2±0.008 9)及24 h尿蛋白定量水平(1.08±0.39 vs 1.65±0.52)g较80 mg治疗组降低更为显著(P<0.05)。结论高剂量缬沙坦(160 mg)更能有效控制血压和降低血压变异性,并具有优越的肾脏保护作用。
Objective To determine the effect of different doses of valsartan on the blood pressure and blood pressure variability in diabetic nephropathy patients undergoing hemodialysis. Methods A total of 54 patients diagnosed diabetic nephropathy （chronic renal failure uremia period ） in our department from December 2006 to June 2012 were recruited in this study. They were 28 males and 26 females. These subjects come from the hemodialysis room of our hospital. All the patients were randomly divided into 2 groups, 80 mg valsartan was served at early morning meal in one group （ n = 25 ） and 160 mg valsartan in another group （ n = 29）. We analyzed the 24 h ambulatory blood pressure and related laboratory index of 2 groups before the treat- ment and after 12 weeks treatment. Results After 12 weeks of treatment, the blood pressure, blood pressure variability and 24 h urinary protein levels were significantly lower than before in the both groups （ P 〈 0.05 ）, the valsartan 160 mg treatment group decreased more significantly than valsartan 80 mg treatment group in night systolic blood pressure （ nSBP, 124.76 ± 7.64 vs 138.57 ± 10.98 mmHg）, night diastolic blood pressure （ nDBP, 74.45 ± 7.25 vs 79.86 ± 7.08 mmHg）, night systolic blood pressure variability （ nSBPV, 0. 069 8 ±0. 011 3 vs O. 074 6 ± 0. 012 5 ）, night diastolic blood pressure variability （ nDBPV, 0. 085 7 ± 0. 009 4 vs 0. 095 2 ± 0. 008 9） and 24 h urinary protein level （ 1.08 ± 0.39 vs 1.65 ± 0.52 g ） （ all P 〈 0.05 ）. Conclu sion Higher dose （ 160 mg） valsartan exerts more significant effect on the control of blood pressure and blood pressure variability, and is superior to 80 mg valsartan in kidney protection in the treatment of diabetes nephritis undergoing hemodialysis.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2014年第7期721-724,共4页
Journal of Third Military Medical University
关键词
缬沙坦
血压变异性
糖尿病肾病
血液透析
高血压
valsartan
blood pressure variability
diabetic nephropathy
hemodialysis
hypertension
