【摘要】 目的观察替米沙坦胶囊联合前列地尔注射液和双嘧达莫片治疗慢性肾小球肾炎的临床疗效及安全性。方法将154例慢性肾小球肾炎患者随机分为对照组和试验组,每组77例。对照组予以双嘧达莫每次50 mg,tid,口服;试验组在对照组治疗的基础上,予以替米沙坦每次80 mg,qd,口服+前列地尔每次10μg,qd,静脉推注。2组患者均治疗4周。比较2组患者的临床疗效、肾功能,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为90. 91%（70例/77例）和64. 94%（50例/77例）,差异有统计学意义（P <0. 05）。治疗后,试验组和对照组的血清肌酸酐分别为（80. 07±10. 13）和（96. 57±11. 35）μmol·L^-1,尿素氮分别为（6. 98±0. 82）和（9. 75±1. 21）mmol·L^-1,24 h尿蛋白定量分别为（0. 62±0. 08）和（1. 17±0. 14） g·24 h-1,血清组织型纤溶酶原激活物分别为（7. 12±1. 01）和（5. 84±0. 75）μg·L^-1,血清Ⅰ型纤溶酶原激活剂抑制物分别为（27. 67±3. 06）和（35. 56±5. 01）μg·L^-1,基质金属蛋白酶-9分别为（99. 84±11. 45）和（136. 37±15. 35）μg·L^-1,纤维蛋白原分别为（2. 95±0. 42）和（3. 17±0. 45） g·L^-1,差异均有统计学意义（均P <0. 05）。试验组出现的药物不良反应主要有头晕头痛、恶心、腹泻和注射部位疼痛,对照组出现的药物不良反应主要有头晕头痛、恶心和腹泻。试验组和对照组的总药物不良反应发生率分别为10. 40%和6. 50%,差异无统计学意义（P> 0. 05）。结论替米沙坦胶囊联合前列地尔注射液和双嘧达莫片治疗慢性肾小球肾炎的临床疗效确切,其能明显改善患者的肾功能,提高血清组织型纤溶酶原激活物水平,延缓肾小球纤维硬化的发生,且不增加药物不良反应的发生率。更多还原

【Abstract】 Objective To observe the clinical efficacy and safety of telmisartan capsules combined with alprostadil injection and dipyridamole tablets in the treatment of chronic glomerulonephritis. Methods A total of 154 patients with chronic glomerulonephritis were randomly divided into control group and treatment group with 77 cases per group. Control group was treated with dipyridamole 50 mg per time,tid,orally. Treatment group was given telmisartan 80 mg per time,qd,orally + alprostadil 10 μg per time,qd,intravenous injection,on the basis of control group. Two groups were treated for 4 weeks. The clinical efficacy,renal function,and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and controlgroups were 90. 91%（ 70 cases/77 cases） and 64. 94%（ 50 cases/77 cases） with significant difference（ P < 0. 05）. After treatment,the main indexes of treatment and control groups were compared: serum creatinine were（ 80. 07 ± 10. 13） and（ 96. 57 ± 11. 35） μmol·L^-1,blood urea nitrogen were（ 6. 98 ± 0. 82） and（ 9. 75 ± 1. 21）mmol·L^-1,24 h urine protein quantitative were（ 0. 62 ± 0. 08） and（ 1. 17 ± 0. 14） g·24 h-1,serum type plasminogen activator were（ 7. 12 ± 1. 01） and（ 5. 84 ± 0. 75） μg·L^-1,serum type I plasminogen activator inhibitor were（ 27. 67 ± 3. 06） and（ 35. 56 ± 5. 01） μg · L^-1,matrix metalloproteinase-9 were（ 99. 84 ± 11. 45） and（ 136. 37 ± 15. 35） μg·L^-1,fibrinogen were（ 2. 95 ± 0. 42） and（ 3. 17 ± 0. 45） g·L^-1,the differences were statistically significant（ all P < 0. 05）. The adverse drug reactions of treatment group were dizziness,headache,nausea,diarrhea and pain of injection site,which in control group were dizziness,headache,nausea and diarrhea. The total incidences of adverse drug reactions in treatment and control groups were 10. 40% and 6. 50% without significant difference（ P > 0. 05）. Conclusion Telmisartan capsules combined with alprostadil injection and dipyridamole tablets have a definitive clinical efficacy in the treatment of chronic glomerulonephritis,which can obviously improve the renal function of patients,improve the level of serum type plasminogen activator,and delay the occurrence of glomerular sclerosis,without increasing the incidence of adverse drug reactions.更多还原