The effect of diminazene,an angiotensin-converting enzyme 2 activator,on adenine-induced chronic kidney disease in rats

The present study investigated the effect of diminazene, lisinopril, or valsartan on adenine-induced chronic kidney disease (CKD) in rats. The animals were divided into five groups (n = 6). The first and second groups received normal diet and adenine in the feed at a dose of 0.25% w/w for 35 days, respectively. The third, fourth, and fifth groups were treated as the second group but also received diminazene (15 mg/kg/day), lisinopril (10 mg/kg/day), and valsartan (30 mg/kg/day), respectively, for 35 days. Adenine significantly increased plasma urea, creatinine, neutrophil gelatinase-associated lipocalin (NGAL), calcium, phosphorus, and uric acid. In addition, adenine increased urinary albumin/creatinine ratio and N-Acetyl-β-D-glucosaminidase (NAG)/creatinine ratio and reduced creatinine clearance. Adenine also significantly increased the plasma concentrations of inflammatory cytokines (plasma tumor necrosis factor–alpha [TNF-α] and interleukin-1beta [IL-1β]) and significantly reduced antioxidant indices (catalase, glutathione reductase [GR], and superoxide dismutase [SOD]). Histopathologically, renal tissue from adenine-treated rats showed necrosis of renal tubules, tubular casts, shrunken glomeruli, and increased renal fibrosis. All drugs ameliorated adenine-induced biochemical and histopathological changes. The protective effect of the three drugs used is, at least partially, due to their anti-inflammatory and antioxidant effects. Our results show that administration of diminazene, lisinopril, or valsartan had a comparable effect on the reversal of the biochemical and histopathological indices of adenine-induced CKD in rats.     

沙库巴曲缬沙坦对经皮冠状动脉介入术后血管内皮功能、心肌损伤和近期预后的影响

目的 探讨沙库巴曲缬沙坦对急性心肌梗死(Acute myocardial infarction,AMI)经皮冠状动脉介入术(Percutaneous cor?onary intervention,PCI)后血管内皮功能、心肌损伤和近期预后的影响.方法 选取2017年6月至2019年3月濮阳油田总医院收治的行PCI治疗的AMI病人97例,随机数字表法分为对照组(48例)与观察组(49例).对照组给予基础用药及比伐卢定治疗,观察组在对照组基础上另给予沙库巴曲缬沙坦治疗.观察应用主动脉内球囊反搏术(Intra-aortic balloon pump,IABP)处理的病人情况,对比治疗前、治疗1d及治疗7d后血管内皮功能相关指标[一氧化氮(NO)、内皮素(ET)、可溶性细胞间黏附因子-1(sICAM-1)]、心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白Ⅰ(cTnⅠ)、心肌肌钙蛋白T(cTnT)]水平变化,比较术后3个月心脏不良事件发生情况.结果 观察组有1例采用IABP治疗,对照组有2例采用IABP治疗,均恢复良好;NO、ET、sI?CAM-1、CK-MB、cTnⅠ、cTnT在组间、时间及交互方面比较差异有统计学意义(P<0.05);观察组治疗1 d后NO、ET、sICAM-1、CK-MB、cTnⅠ、cTnT水平分别为(62.19±7.04)μmol/L、(73.48±6.49)mg/L、(190.62±16.35)ng/L、(113.38±19.45)U/L、(2.81±0.53)μg/L、(0.66±0.17)μg/L,治疗7 d后分别为(86.19±10.24)μmol/L、(42.69±5.13)mg/L、(160.75±14.36)ng/L、(62.36±13.69)U/L、(1.21±0.34)μg/L、(0.21±0.06)μg/L;对照组治疗1 d后NO、ET、sICAM-1水平分别为(58.45±6.38)μmol/L、(78.06±7.01)mg/L、(198.34±17.59)ng/L、(122.59±20.06)U/L、(3.19±0.57)μg/L、(0.75±0.21)μg/L,治疗7 d后分别为(73.61±9.38)μmol/L、(54.87±5.39)mg/L、(176.62±14.51)ng/L、(75.74±14.58)U/L、(1.49±0.41)μg/L、(0.33±0.09)μg/L,两组治疗1 d及7 d后NO均高于治疗前,两组治疗7 d后NO均高于治疗1 d,观察组治疗1 d及7 d后均高于对照组,差异有统计学意义(P<0.05);两组治疗1 d及7 d后ET、sICAM-1、CK-MB、cTnⅠ、cTnT均低于治疗前,两组治疗7 d后ET、sICAM-1、CK-MB、cTnⅠ、cTnT均高于治疗1 d,观察组治疗1 d及7 d后均低于对照组,差异有统计学意义(P<0.05);观察组术后3个月总心脏不良事件发生率为12.24％,低于对照组的29.17％,差异有统计学意义(P<0.05).结论 沙库巴曲缬沙坦可改善AMI病人PCI术后血管内皮功能,减轻心肌损伤,并可改善近期预后,可推广应用于临床治疗中.     

健脾补肾、益气祛浊法治疗糖尿病肾病Ⅲ期的疗效观察及对免疫功能的影响

[目的]观察健脾补肾、益气祛浊法治疗糖尿病肾病Ⅲ期患者的临床疗效及对免疫功能的影响.[方法]选择糖尿病肾病Ⅲ期患者,随机分为对照组和治疗组,两组均接受常规治疗及护理.对照组口服缬沙坦胶囊,80 mg/次,每日1次.治疗组在对照组的基础上加用中药汤剂口服.疗程8周,治疗前后进行疗效性观察指标、肾功能损害相关指标、免疫功能...     

Role of angiotensin receptor blockers in the context of Alzheimer's disease

As the world's population ages, the prevalence of age-related neurological disorders such as Alzheimer's disease (AD) is increasing. There is currently no treatment for Alzheimer's disease, and the few approved medications have a low success rate in lowering symptoms. As a result, several attempts are underway worldwide to identify new targets for the therapy of Alzheimer's disease. In preclinical studies of Alzheimer's disease, it was recently found that inhibition of angiotensin-converting enzyme (ACE) and blocking of the angiotensin II receptors reduce symptoms of neurodegeneration, Aβ plaque development, and tau hyperphosphorylation. Angiotensin II type I (AT1) blockers, such as telmisartan, candesartan, valsartan, and others, have a wide safety margin and are commonly used to treat hypertension. Renal and cardiovascular failures are reduced due to their vascular protective actions. Inhibition of AT1 receptors in the brain has a neuroprotective impact in humans, reducing the risk of stroke, increasing cognition, and slowing the progression of Alzheimer's disease. The review focuses on the mechanisms via which AT1 blockers may act beneficially in Alzheimer's disease. Although their effect is evident in preclinical studies, clinical trials, on the other hand, are in short supply to validate the strategy. More dose–response experiments with possible AT1 blockers and brain-targeted administration will be needed in the future.     

注射用益气复脉（冻干）联合沙库巴曲缬沙坦治疗慢性心力衰竭的疗效观察

目的 观察注射用益气复脉（冻干）联合沙库巴曲缬沙坦治疗慢性心力衰竭的治疗效果。方法 选择2021年1月—2022年12月河北省退役军人总医院心内科、荣军二科收治的慢性心衰住院患者106例为研究对象，根据患者治疗方案不同分为对照组和试验组，每组各53例。对照组患者给予常规药物（袢利尿剂、螺内酯、β受体阻滞剂）＋沙库巴曲缬沙坦钠片（口服每次100 mg，每天2次，依据患者耐受程度，酌情增减剂量，最大剂量为每次200 mg）治疗，试验组患者在对照组基础上加用注射用益气复脉（冻干），注射用益气复脉（冻干）5.2 g溶于0.9%氯化钠注射液250 mL中，静脉滴注，每天1次。两组均治疗4周。对比两组临床疗效，比较治疗前后两组患者氨基端前心钠肽（NT-proBNP）、左室射血分数（LVEF）、6分钟步行试验距离（6MWD）、明尼苏达州心功能不全生命质量量表（MLHFQ）评分，同时观察两组患者的不良反应。结果 经过4周治疗后，试验组总有效率为88.68%，显著高于对照组的73.58%（P＜0.05）。治疗前两组患者NT-proBNP、LVEF、6MWD、MLHFQ评分比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者NT-proBNP及MLHFQ评分均较本组治疗前显著降低（P＜0.05），且试验组显著低于对照组（P＜0.05）；治疗后，两组患者LVEF和6MWD均较本组治疗前显著增加（P＜0.05），且试验组显著高于对照组（P＜0.05）。对照组发生1例不良反应，试验组未发生不良反应，两组比较，差异无统计学意义（P＞0.05）。结论 注射用益气复脉（冻干）联合沙库巴曲缬沙坦治疗慢性心力衰竭具有较好的临床疗效，且安全性较高。     

缬沙坦和氨氯地平联合治疗对成人高血压病人血压及血压变异性的影响研究

目的: 评价缬沙坦和氨氯地平联合治疗高血压的疗效及该用药方案对病人血压变异性的改善作用，
为高血压治疗中药物合理应用提供可靠证据。方法: 收集2013－10 ～ 2016－03 于我院就诊的≥18 岁的高血压病
人共124 例纳入研究; 以上入选病例按数字表法分至A、B 两组，进行为期12wk 的临床降压治疗对照试验; 其中
A 组给予缬沙坦+氨氯地平固定剂量口服治疗，B 组则给予缬沙坦+氢氯噻嗪固定剂量口服治疗; 主要评价指标
为入组基线以及治疗6wk、12wk 各时点降压效果及血压变异性的比较，次要评价指标为2 组6wk 末的血压达标
率及治疗过程中的新发不良事件记录。结果: 与治疗前基线参数相比，A、B 两组治疗6wk 和12wk 时24h SBP、
日间SBP、夜间SBP、晨峰SBP 及SBPV 水平均明显下降，统计学差异具有显著性( P＜0．05) ; 组间t 检验显示，与
B 组比较，A 组治疗6wk 及12wk 时，24h SBP、日间SBP、夜间SBP 及日间SBPV 水平均进一步下降( 均P＜0．05) ，
而治疗12wk 时，A 组24h SBPV 水平显示更低( P＜0．05) 。在治疗6wk 末的血压达标率和疗程中新发不良事件
的比较中，两组指标的统计学差异没有显著性( 均P＞0．05) 。结论: 在成人高血压治疗中，固定剂量下的缬沙坦
联合氨氯地平的用药方案，降压效果可靠，血压变异小，在血压控制和降低血压变异性方面，较缬沙坦联合氢氯
噻嗪的治疗方案更有优势。