川芎嗪联合厄贝沙坦对高血压早期肾损害的防治作用

目的探讨川芎嗪联合血管紧张素Ⅱ受体拮抗剂厄贝沙坦对高血压早期肾损害的防治效果。方法 108例轻、中度原发性高血压伴早期肾损害患者随机分为厄贝沙坦组（n=36）、川芎嗪组（n=36）及川芎嗪联合厄贝沙坦组（n=36）,进行12周治疗。在治疗前后检测各组血α1-微球蛋白（α1-MG）,血、尿β2-微球蛋白（β2-MG）水平并同时监测肾脏双侧叶段动脉（SRA）﹑叶间动脉（IRA）的收缩期峰速度（Vs）、舒张期末血流速度（Vd）、平均血流速度（Vm）、血流峰速加速时间（AT）、脉冲指数（PI）、阻力指数（RI）的变化并进行分析。结果川芎嗪组患者治疗前血α1-MG,血、尿β2-MG水平分别为（29.5±4.85）mg/L、（3860.7±313.2）μg/L、（186.3±15.1）μg/L,治疗后降为（19.0±4.11）mg/L、（3109.5±301.3）μg/L、（136.1±14.5）μg/L;厄贝沙坦组患者治疗前血α1-MG,血、尿β2-MG水平分别为（29.3±4.79）mg/L、（3845.4±307.1）μg/L、（185.5±14.7）μg/L,治疗后降低为（18.9±3.79）mg/L、（2985.4±290.9）μg/L、（135.9±14.1）μg/L;川芎嗪联合厄贝沙坦组患者治疗前血α1-MG,血、尿β2-MG水平分别为（29.6±4.82）mg/L、（3864.2±311.3）μg/L、（185.8±114.8）μg/L,治疗后降为（14.4±3.58）mg/L、（2107.6±282.5）μg/L、（105.3±13.9）μg/L;SRA、IRA的Vs、Vd、Vm增高（P〈0.05）,AT缩短（P〈0.05）,PI和RI降低（P〈0.05）,以川芎嗪联合厄贝沙坦组改变最为明显。结论川芎嗪与厄贝沙坦均可对高血压早期肾损害发挥防治作用,两者联合使用防治效果更佳。

Effect of ligustrazine combined with irbesartan on early renal damage of hypertension

Objective To investigate the preventive and curative effect of ligustrazine combined with the antagonist of angiotensin II receptor,irbesartan,on early renal damage of hypertension.Methods The patients （n=108） with mild or moderate essential hypertension accompanied by early renal damage were randomly divided into the irbesartan group （n=36）,ligustrazine group （n=36） and group of ligustrazine combined with irbesartan （combined group,n=36）.All groups were treated for 12 weeks.The levels of α1-microglobulin （α1-MG） in blood and β2-microglobulin （β2-MG） in blood and urine were detected,and at the same time the changes of systolic peak velocity （Vs）,diastolic end blood flow velocity （Vd）,mean flow velocity （Vm）,peak velocity flow acceleration time （AT）,pulse index （PI） and resistance index （RI） of bilateral lobe segmental arteries （SRA） and interlobar artery （IRA） were monitored and analysed before and after treatment.Results In the ligustrazine group the levels of α1-MG in blood and β2-MG in blood and urine were,respectively,（29.5±4.85） mg/L,（3860.7±313.2） μg/L and （186.3±15.1） μg/L before the treatment,and reduced to （19.0±4.11） mg/L,（3109.5±301.3） μg/L and （136.1±14.5） μg/L after the treatment.In the irbesartan group the levels of α1-MG in blood and β2-MG in blood and urine were,respectively,（29.3±4.79） mg/L,（3845.4±307.1） μg/L and （185.5±14.7） μg/L before the treatment,and reduced to （18.9±3.79） mg/L,（2985.4±290.9） μg/L and （135.9±14.1） μg/L after the treatment.In the combined group the levels of α1-MG in blood and β2-MG in blood and urine were,respectively,（29.6±4.82） mg/L,（3864.2±311.3） μg/L and （185.8±114.8） μg/L before the treatment,and reduced to （14.4±3.58） mg/L,（2107.6±282.5） μg/L and （105.3±13.9） μg/L after the treatment.In all groups Vs,Vd and Vm of SRA and IRA increased （P0.05）,AT was shortened （P0.05） and PI and RI decreased （P0.05） but those were more significant in the combined group.Conclusion Ligustrazine and irbesartan all have the preventive and therapeutic effect on early renal damage of hypertension,while the effect will be better if two of them are combined.