不同剂量替米沙坦联合低分子肝素治疗IgA肾病尿蛋白的临床观察

目的 探讨替米沙坦联合低分子肝素治疗对IgA肾病患者的尿蛋白、血压控制及肾功能的保护作用.方法 49例IgA肾病患者随机分成三组,第一组给予常规用量替米沙坦80 mg口服治疗；第二、第三组分别给予80 mg及160 mg不同剂量的替米沙坦治疗,且每日皮下注射低分子肝素钙4100U.检测血常规、血浆白蛋白、血尿素氮、血钾、血肌酐、尿蛋白定量等指标.结果 所有患者在服用替米沙坦和皮下注射低分子肝素钙后尿蛋白均有不同程度下降,总有效率:第一组为75.0％,第二组为75.0％,第三组为82.3％.结论 替米沙坦联合低分子肝素对IgA肾病患者有明显的降低蛋白尿的作用,大剂量替米沙坦组的治疗效果更显著(P＜0.01)；对于非高血压的IgA肾病患者,服药前后血压均无明显差异(P＞0.05).

Treatment of urinary protein with IgA nephropathy by different doses of telmisartan combined low molecular weight heparin

Objective To discussion the treatment of urinary protein blood pressure control and renal function for patients with IgA nephropathy by telmisartan combining low molecular heparin.Methods 49 cases of IgA nephropathy was randomly divided into 3 groups.The 1st group was given normol doses of 80mg telmisartan treatment.The other two groups were given different doses of 80mg and 160mg telmisartan treatment,and were daily subcutaneous low molecular weight heparin 4100U at the same time.The blood lipid,serum albumin,blood urea nitrogen,serum potassium and serum creatinine of patients were test.Results After taking talmisartan and subcutaneous low molecular weight heparin,urinary protein of all patients decreased in varying degrees.Overall efficiency： the 1st group was 75.0%,the 2nd group was 75.0%,the 3rd group was 82.3%.Conclusion Telmisartan combing low molecular weight heparin in patients with IgA nephropathy proteinuria significantly reduced the role of high-dose telmisartan treatment effect is more pronounced（P0.01）,For non-hypertensive patients with IgA nephropathy,there was no significant difference in blood pressure before and after medication（P0.05）.