摘要
目的探讨缬沙坦对高血压合并糖尿病肾病(DN)抗血管紧张素Ⅱ1型受体(AT1R)自身抗体阳性(AT1R+)和阴性(AT1R-)患者血压和尿蛋白的影响。方法以合成的AT1R多肽片段为抗原,应用酶联免疫吸附测定(ELISA)技术,对高血压合并DN患者166例及正常人对照组60例,进行血清抗AT1R自身抗体检测后,给予口服:缬沙坦160mg,1次/d,尼群地平10mg,1次/6h;阿司匹林100mg,1次/d。观察降压疗效,12周为一疗程;观察对蛋白尿的影响,6及12月为一疗程,治疗前后行24h尿微量白蛋白测定。结果1)高血压合并DN组抗AT1R自身抗体阳性率(60.8%,101/166),明显高于对照组(8.3%,5/60);2)经上述治疗后抗AT1R+组降压达标率为(85%),明显高于(AT1R-)组降压达标率(25%)(P<0.01);临床疗效总评定,抗AT1R+组,缬沙坦治疗总有效率为93.1%,AT1R-组总有效率为44.6%(P<0.01);3)缬沙坦对抗AT1R+组减少蛋白尿明显优于AT1R-组。结论缬沙坦治疗降压和减少蛋白尿的疗效在高血压合并DN抗AT1R自身抗体阳性组明显优于阴性组。
Objective To investigate the effects of valsartan on the patients of hypertension complicated with diabetic nephropathy with positive angiotensin Ⅱ 1 receptor autoantibodies receptor（AT1R^＋ ）. .Methods The epitopes of the second extracellular loop of AT1R （165-191 ） was synthesized and used to screen the serum autoantibodies from patients hypertension with diabetic nephropathy （DN） （ n= 166 ） and healthy blood donors （ n =60） by ELISA. Patients were subdivided as positive of the autoantibodies against AT1R （ AT1R^＋ , n= 101 ） patients and negative autoantibodies （AT1R^- , n：65） and received valsartan 160 rag/d, aspirin 100 mg/d, nitrendipine 10 rag/6 h for 12 weeks. The 24-hour urinary protein（UAER） were measused. Results In patients hypertension with DN, the prevalence rate of AT1R^＋ was 60.8 %（101/166）, higher than those of the healthy blood donors（8. 3%, 5/60）. Valsartan treatment significantly improved UAER in AT1R^＋ patients compared with AT1R^- patients as well as the BP response rate [ AT1R^＋ （ 93. 1 % ） vs AT1R^- （ 44.6） ） , （ P〈0.01 ） ]. Conclusion Valsartan significantly protects renal function and reduces urinary protein in patients of hypertension with diabetie nephropathy and positive autoantibodies against AT1R.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2007年第6期469-472,共4页
Chinese Journal of Hypertension
基金
湖北省自然科学基金项目(2002AB116)
关键词
高血压合并糖尿病肾病
抗AT1R自身抗体
缬沙坦
尿蛋白
Hypertension with diabetic nephropathy
Valsartan
Angiotensin Ⅱ 1 receptor autoantibodies
Urinary protein
