高剂量缬沙坦对老年DKD伴高血压患者血压控制、超声心动图及血清TM、vWF的影响研究.docVIP

ADDINCNKISM.UserStyle高剂量缬沙坦对老年DKD伴高血压患者血压控制、超声心动图及血清TM、vWF的影响研究

【摘要】目的探究高剂量缬沙坦对老年糖尿病肾脏疾病（DKD）伴高血压患者血压控制、超声心动图及血清凝血酶调节蛋白（TM）、凝血因子Ⅷ（vWF）的影响。方法150例DKD伴高血压患者随机分为低剂量组（80mg/d，n=75）和高剂量组（160mg/d，n=75），对两组治疗前及治疗3个月后血压[收缩压（SBP）、舒张压（DBP）]、超声心动图指标[左室射血分数（LVEF）、左室收缩末内径（LVESD）、左室舒张末内径（LVEDD）]及血清TM、vWF进行测定，并观察两组不良反应。结果治疗后，两组SBP、DBP、LVESD、LVEDD、TM、vWF水平相比治疗前均明显降低（P0.05），LVEF相比治疗前明显提高（P0.05），且高剂量组上述指标改善优于低剂量组（P0.05）。两组不良反应发生率对比无统计学差异（P0.05）。结论高剂量缬沙坦治疗DKD伴高血压患者效果佳，能够更好地控制血压，改善患者心功能，降低血清TM、vWF水平，且安全性较高。

【关键词】糖尿病肾脏疾病；缬沙坦；血压；心功能；血管内皮损伤

Effectsofhigh-dosevalsartanonbloodpressurecontrol,echocardiogram,serumTMandvWFinelderlypatientswithDKDcomplicatedwithhypertension

[Abstract]ObjectiveToinvestigatetheeffectsofhigh-dosevalsartanonbloodpressurecontrol,echocardiogram,serumthrombomodulin(TM)andvonWillebrandfactor(vWF)inelderlypatientswithdiabetickidneydisease(DKD)complicatedwithhypertension.Methods150patientswithDKDandhypertensionwererandomizedintolow-dosegroup(80mg/d,n=75)andhigh-dosegroup(160mg/d,n=75).Bloodpressure[systolicbloodpressure(SBP),diastolicbloodpressure(DBP)],echocardiogramindexes[leftventricularejectionfraction(LVEF),leftventricularend-systolicdiameter(LVESD),leftventricularend-diastolicdiameter(LVEDD)],serumTMandvWFofthetwogroupsweredeterminedbeforeandaftertreatment.Besides,adversereactionsinthetwogroupswereobserved.ResultsAftertreatment,SBP,DBP,LVESD,LVEDD,TMandvWFlevelsofbothgroupsweresignificantlylowerthanthosebeforetreatment(P0.05),whiletheLVEFwassignificantlyhigherthanthatbeforetreatment(P0.05).Theimprovementofaboveindexeswasbetterinhigh-dosegroupthanthelow-dosegroup(P0.05).Therewasnosignificantdifferenceintheincidencerateofadversereactionsbetweenthetwogroups(P0.05).ConclusionHigh-dosevalsartaniseffectiveinthetreatmentofpatientswithDKDandhypertens