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目的观察缬沙坦治疗冠心病并慢性肾功能不全的临床疗效,并探讨其对转化生长因子β1(TGF-β1)、内皮素(ET)水平的影响。方法选取2013年2月—2015年2月昆山市第一人民医院收治的冠心病并慢性肾功能不全患者94例,采用随机数字表法分为对照组和观察组,每组47例。对照组患者给予常规药物治疗,观察组患者在常规药物治疗基础上给予缬沙坦治疗。比较两组患者临床疗效,治疗前后血肌酐、尿素氮、24 h尿蛋白定量及TGF-β1、ET水平,治疗后收缩压和舒张压;记录治疗过程中不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。两组患者治疗前血肌酐、尿素氮及24 h尿蛋白定量比较,差异无统计学意义(P>0.05);观察组患者治疗后血肌酐、尿素氮及24 h尿蛋白定量均低于对照组(P<0.05)。两组患者治疗前TGF-β1、ET水平比较,差异无统计学意义(P>0.05);观察组患者治疗后TGF-β1、ET水平均低于对照组(P<0.05)。观察组患者治疗后收缩压、舒张压均低于对照组(P<0.05)。观察组患者治疗过程中国不良反应发生率低于对照组(P<0.05)。结论缬沙坦可有效提高冠心病并慢性肾功能不全患者临床疗效,改善患者肾功能,降低TGF-β1、ET水平及血压,且不良反应较少。
Objective To observe the clinical efficacy of valsartan in the treatment of coronary heart disease and chronic renal insufficiency and to explore its effect on the levels of transforming growth factor β1 (TGF-β1) and endothelin (ET). Methods From February 2013 to February 2015, 94 patients with coronary heart disease and chronic renal failure admitted to First People’s Hospital of Kunshan City were randomly divided into control group and observation group with 47 cases in each group. The control group of patients given conventional drug treatment, the observation group of patients on the basis of conventional drug treatment given valsartan treatment. The clinical efficacy, serum creatinine, urea nitrogen, 24 h urinary protein and TGF-β1, ET levels, systolic and diastolic blood pressure were compared between the two groups before and after treatment. Adverse reactions were recorded during the treatment. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). There was no significant difference in serum creatinine, urea nitrogen and 24 h urinary protein before treatment between the two groups (P> 0.05). The serum creatinine, urea nitrogen and 24 h urinary protein in the observation group after treatment were lower than those in the control group (P <0.05). The levels of TGF-β1 and ET before treatment in the two groups were not statistically different (P> 0.05). The levels of TGF-β1 and ET in the observation group were lower than those in the control group after treatment (P <0.05). Systolic blood pressure and diastolic blood pressure were lower in the observation group than those in the control group (P <0.05). In the observation group, the incidence of adverse reactions in China was lower than that of the control group (P <0.05). Conclusion Valsartan can effectively improve the clinical efficacy of patients with coronary heart disease and chronic renal failure, improve renal function, reduce the levels of TGF-β1, ET and blood pressure, with less adverse reactions.