丹参酮治疗高血压肾病的临床研究

目的:探讨丹参酮对高血压肾病的治疗作用。方法:选择符合高血压肾病入选标准的慢性肾病(CKD)Ⅰ~Ⅲ期患者60例,基础治疗全部用氯沙坦,随机分为丹参酮组、基础治疗对照组,治疗用药2周,检测并比较各组血压、肾功能、24 h尿蛋白定量、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)等的变化。结果:2组治疗前、后血压变化无明显差异;丹参酮组治疗2周时血肌酐(SCr)水平较基线下降(162.2±10.1)μmol/L比(134.0±7.1)μmol/L],与对照组治疗2周时(151.8±8.3)μmol/L]比较差异有统计学意义(P<0.05),但治疗后组间比较无明显差异。与基线相比,丹参酮组尿NAG下降有明显差异,氯沙坦组无明显下降趋势。结论:在氯沙坦降低蛋白尿的基础上,丹参酮还具有保护肾小管功能及延缓肾功能进展的作用,且安全性好,是高血压肾病治疗的可选药物之一。

Clinical study of hypertensive nephropathy treated with tanshinone

Objective To study the effect of tanshinone on treatment of hypertensive nephropathy.Methods Sixty hypertensive nephropathy（chronic kidney disease Ⅰ —Ⅲstage） patients with losartan as basic treatment were enrolled and divided randomly into 2 groups： basic treatment control group and tanshinone treatment group.After 2 weeks of treatment,the blood pressure,renal function,24 h proteinuria,and N-acetyl-β-D-glucosaminidase（NAG）were assayed.Results There was no significant difference between the two groups in blood pressure change before and after treatment.After 2 weeks of tanshinone treatment,serum creatinine（SCr） level decreased significantly from（162.2±10.1） μmol/L to（134.0±7.1） μmol/L] and the estimated glomerular filtration rate（eGFR）increased significantly（P0.05）.SCr level did not change significantly in control group.Urinary protein decreased in each group,and no significant difference was seen between the two groups.Urinary NAG decreased significantly in tanshinone group but not in control group.Conclusions Tanshinone had an effect of protecting renal tubular function and delaying the progression of renal dysfunction.It is safe and may be one of the optional drugs for treatment of hypertensive nephropathy.