非洛地平联合厄贝沙坦对青年男性原发性高血压患者血尿酸、血清脂联素及肾功能的影响
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摘要
目的:探讨非洛地平联合厄贝沙坦对青年男性原发性高血压(EH)患者血尿酸(UA)、血清脂联素(APN)及肾功能的影响。方法:选取青年男性EH患者134例为研究对象,随机分为观察组和对照组,对照组患者口服非洛地平缓释片5 mg/次,1次/d,观察组在对照组基础上口服厄贝沙坦150 mg/次,1次/d,两组患者4周后血压未降至140/90mmHg以下,非洛地平缓释片增加至10mg/d,达理想降压效果后,依个体情况改为维持量。两组于治疗前和治疗4、12周后,采集清晨空腹静脉血,采用ELISA法测定APN水平,尿酸酶-过氧化物酶法测定UA水平,采用全自动生化分析仪测定血尿素氮(BUN)、血清肌酐(Scr),计算内生肌酐清除率(Ccr);留取尿液,放射免疫法测定24h尿蛋白定量(24h Upro)。采集治疗前和治疗24、48周后清晨空腹静脉血,采用放射性免疫法测定血清睾酮(T)、性激素结合球蛋白(SHBG)水平。结果:两组治疗4、12周后Scr、24hUpro逐渐降低,Ccr逐渐升高,观察组治疗12周后BUN降低(P<0.05),而观察组治疗4、12周后Scr、24hUpro低于同期对照组,Ccr高于同期对照组,观察组治疗12周后BUN低于同期对照组(P<0.05);两组治疗24、48周后T水平逐渐升高(P<0.05),治疗后SHBG无明显变化,而观察组治疗24、48周后T水平高于同期对照组(P<0.05);两组治疗4、12周后APN逐渐升高,UA逐渐降低(P<0.05),且观察组治疗4、12周后APN高于同期对照组,UA低于同期对照组(P<0.05)。结论:非洛地平联合厄贝沙坦治疗青年男性EH可有效调节APN、UA水平,保护肾功能,提高性激素水平,在降低靶器官损伤和改善预后方面具有重要意义。
Objective:To explore the effect of felodipine in combined with irbesartan on the blood uric acid(UA),serum adiponectin(APN),and renal function in young males with essential hypertension(EH).Methods:A total of 134 young male patients with EH who were admitted in our hospital from January,2016 to January,2017 were included in the study and randomized into the observation group and the control group.The patients in the control group were given felodipine sustanined release tablets,5 mg/time,1 time/d.On this basis,the patients in the observation group were given irbesartan,150 mg/time,1 time/d.To those whose blood pressure was not reduced under 140/90 mmHg after 4-week treatment,the dose of felodipine sustanined release tablets was increased to 10 mg/d.A maintenance dose was adopted according to the individual conditions until the ideal blood pressure reduction effect was achieved.The morning fasting venous blood was collected before treatment,4 and 12 weeks after treatment in the two groups.ELISA was used to detect APN level.Uricase-peroxide enzymic method was used to detect UA level.The full automatic biochemical analyzer was used to detect BUN and Scr.Ccr was calculated.Urine was collected.RIA was used to detect 24 hUpro.The morning fasting venous blood before treatment,24 and 48 weeks after treatment was collected.RIA was used to detect the serum T and SHBG levels.Results:Scr and 24 hUpro 4 and 12 weeks after treatment in the two groups were gradually reduced,while Ccr was gradually elevated.BUN 12 weeks after treatment in the observation group was significantly reduced(P<0.05).Scr and 24 hUpro 4 and 12 weeks after treatment in the observation group were significantly lower than those in the control group,while Ccr was significantly higher than that in the control group(P<0.05).BUN 12 weeks after treatment in the observation group were significantly lower than those in the control group(P<0.05).T level 24 and 48 weeks after treatment in the two groups was significantly elevated(P<0.05),while SHBG after treatment was not significantly changed.T level 24 and 48 weeks after treatment in the observation group was significantly higher than that in the control group(P<0.05).APN 4 and 12 weeks after treatment in the two groups was significantly elevated,while UA was significantly reduced(P<0.05).APN 4 and 12 weeks after treatment in the observation group was significantly higher than that in the control group,while UA was significantly lower than that in the control group(P<0.05).Conclusions:Felodipine in combined with irbesartan in the treatment of EH in young males can effectively regulate APN and UA levels,protect the renal function,enhance the sex hormone levels,and has a great significance in reducing the target organ damage and improving the prognosis.
Objective:To explore the effect of felodipine in combined with irbesartan on the blood uric acid(UA),serum adiponectin(APN),and renal function in young males with essential hypertension(EH).Methods:A total of 134 young male patients with EH who were admitted in our hospital from January,2016 to January,2017 were included in the study and randomized into the observation group and the control group.The patients in the control group were given felodipine sustanined release tablets,5 mg/time,1 time/d.On this basis,the patients in the observation group were given irbesartan,150 mg/time,1 time/d.To those whose blood pressure was not reduced under 140/90 mmHg after 4-week treatment,the dose of felodipine sustanined release tablets was increased to 10 mg/d.A maintenance dose was adopted according to the individual conditions until the ideal blood pressure reduction effect was achieved.The morning fasting venous blood was collected before treatment,4 and 12 weeks after treatment in the two groups.ELISA was used to detect APN level.Uricase-peroxide enzymic method was used to detect UA level.The full automatic biochemical analyzer was used to detect BUN and Scr.Ccr was calculated.Urine was collected.RIA was used to detect 24 hUpro.The morning fasting venous blood before treatment,24 and 48 weeks after treatment was collected.RIA was used to detect the serum T and SHBG levels.Results:Scr and 24 hUpro 4 and 12 weeks after treatment in the two groups were gradually reduced,while Ccr was gradually elevated.BUN 12 weeks after treatment in the observation group was significantly reduced(P<0.05).Scr and 24 hUpro 4 and 12 weeks after treatment in the observation group were significantly lower than those in the control group,while Ccr was significantly higher than that in the control group(P<0.05).BUN 12 weeks after treatment in the observation group were significantly lower than those in the control group(P<0.05).T level 24 and 48 weeks after treatment in the two groups was significantly elevated(P<0.05),while SHBG after treatment was not significantly changed.T level 24 and 48 weeks after treatment in the observation group was significantly higher than that in the control group(P<0.05).APN 4 and 12 weeks after treatment in the two groups was significantly elevated,while UA was significantly reduced(P<0.05).APN 4 and 12 weeks after treatment in the observation group was significantly higher than that in the control group,while UA was significantly lower than that in the control group(P<0.05).Conclusions:Felodipine in combined with irbesartan in the treatment of EH in young males can effectively regulate APN and UA levels,protect the renal function,enhance the sex hormone levels,and has a great significance in reducing the target organ damage and improving the prognosis.
引文
1曹立平,徐青,洪丽萍,等.原发性高血压患者同型半胱氨酸水平与动脉病变及左心室肥厚关系的临床研究[J].中国循环杂志,2015,30(2):133-135.
2 刘佳梅,刘佳,蔡军,等.原发性高血压相关代谢组学的初步研究[J].中华高血压杂志,2016,24(4):340-347.
3 伍立涛,李志娟.LVEF正常的原发性高血压患者晨峰血压对肾功能损害的影响分析[J].医学理论与实践,2017,30(3):359-360.
4 秦广民.厄贝沙坦联合非洛地平对原发性高血压患者血清脂联素和尿酸水平的影响分析[J].中国医疗前沿,2013,8(12):25-26.
5 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].中华高血压杂志,2011,19(8):701-703.
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7 罗天勇,李一梅,谢波,等.氨氯地平与缬沙坦分别联合氢氯噻嗪对控制原发性高血压血压的系统评价[J].重庆医学,2015,44(5):673-675.
8 王欢,刘海明,胡广梅,等.原发性高血压病患者血清25-羟基维生素D水平与血压变异性的相关性研究[J].中国全科医学,2015,18(4):399-404.
9 姜亚莉,袁晓晨,张昕,等.依拉地平与非洛地平治疗原发性高血压的临床效果观察[J].临床合理用药,2015,8(7A):32-33.
10 闫海.甲磺酸氨氯地平与非洛地平治疗原发性高血压的疗效观察[J].中西医结合心血管病杂志,2016,4(13):45-46.
11 刘楠楠,朱芳一,刘彦民.硝苯地平控释片联合厄贝沙坦片治疗原发性高血压疗效观察[J].青海医药杂志,2016,46(10):21-22.
12 郝继晖,邴兰香.厄贝沙坦及倍他乐克对高血压患者动态血压的影响[J].实用临床医药杂志,2014(5):81-83.
13 邵贵峰,汪茂宝,杨方成.瑞舒伐他汀联合厄贝沙坦对原发性高血压早期肾损伤患者肾脏功能及其他实验室指标的影响[J].安徽医学,2016,37(5):553-556.
14 杜晓马,蔡建丽,沈昕.非洛地平缓释片联合厄贝沙坦片对男性高血压患者勃起功能的影响[J].中国男科学杂志,2014,28(11):43-45.
15 罗小英,陈兆俊.美托洛尔联合厄贝沙坦对男性高血压ED患者血清性激素水平的影响[J].中国性科学,2014,23(2):37-39.
16 张长群,许骥,张娈和,等.原发性高血压患者血清高敏C反应蛋白、脂联素、一氧化氮和内皮素1水平的变化[J].中华高血压杂志,2014,22(11):1078-1080.
17 于璟,田爱娟,袁欣,等.高血压患者血尿酸水平与早期肾功能损伤的相关性研究[J].检验医学与临床,2015,12(19):2948-2950.
18 张美雪.高血压患者同型半胱氨酸、尿酸、超敏C-反应蛋白及脂蛋白a检测的临床意义[J].吉林医学,2016,37(11):2791-2792.
2 刘佳梅,刘佳,蔡军,等.原发性高血压相关代谢组学的初步研究[J].中华高血压杂志,2016,24(4):340-347.
3 伍立涛,李志娟.LVEF正常的原发性高血压患者晨峰血压对肾功能损害的影响分析[J].医学理论与实践,2017,30(3):359-360.
4 秦广民.厄贝沙坦联合非洛地平对原发性高血压患者血清脂联素和尿酸水平的影响分析[J].中国医疗前沿,2013,8(12):25-26.
5 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].中华高血压杂志,2011,19(8):701-703.
6 高金钗,彭伟.原发性高血压病因、危险因素及治疗研究进展[J].河北北方学院学报(自然科学版),2016,32(2):44-54.
7 罗天勇,李一梅,谢波,等.氨氯地平与缬沙坦分别联合氢氯噻嗪对控制原发性高血压血压的系统评价[J].重庆医学,2015,44(5):673-675.
8 王欢,刘海明,胡广梅,等.原发性高血压病患者血清25-羟基维生素D水平与血压变异性的相关性研究[J].中国全科医学,2015,18(4):399-404.
9 姜亚莉,袁晓晨,张昕,等.依拉地平与非洛地平治疗原发性高血压的临床效果观察[J].临床合理用药,2015,8(7A):32-33.
10 闫海.甲磺酸氨氯地平与非洛地平治疗原发性高血压的疗效观察[J].中西医结合心血管病杂志,2016,4(13):45-46.
11 刘楠楠,朱芳一,刘彦民.硝苯地平控释片联合厄贝沙坦片治疗原发性高血压疗效观察[J].青海医药杂志,2016,46(10):21-22.
12 郝继晖,邴兰香.厄贝沙坦及倍他乐克对高血压患者动态血压的影响[J].实用临床医药杂志,2014(5):81-83.
13 邵贵峰,汪茂宝,杨方成.瑞舒伐他汀联合厄贝沙坦对原发性高血压早期肾损伤患者肾脏功能及其他实验室指标的影响[J].安徽医学,2016,37(5):553-556.
14 杜晓马,蔡建丽,沈昕.非洛地平缓释片联合厄贝沙坦片对男性高血压患者勃起功能的影响[J].中国男科学杂志,2014,28(11):43-45.
15 罗小英,陈兆俊.美托洛尔联合厄贝沙坦对男性高血压ED患者血清性激素水平的影响[J].中国性科学,2014,23(2):37-39.
16 张长群,许骥,张娈和,等.原发性高血压患者血清高敏C反应蛋白、脂联素、一氧化氮和内皮素1水平的变化[J].中华高血压杂志,2014,22(11):1078-1080.
17 于璟,田爱娟,袁欣,等.高血压患者血尿酸水平与早期肾功能损伤的相关性研究[J].检验医学与临床,2015,12(19):2948-2950.
18 张美雪.高血压患者同型半胱氨酸、尿酸、超敏C-反应蛋白及脂蛋白a检测的临床意义[J].吉林医学,2016,37(11):2791-2792.