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目的研究尼可地尔对血压控制正常的高血压肾病患者尿蛋白的治疗作用及其与HSCRP和IL6的关系。方法 52例血压控制正常的高血压肾病患者随机分为对照组(26例)或尼可地尔组(26例),分别给与尼可地尔(10mgTid)或安慰剂治疗3月,观察血压、血浆超敏C反应蛋白(HSCRP)、白介素6(IL6)、24h尿蛋白(U-pro)、肌酐(Cr)、尿素氮(Bun)的变化。结果治疗3月后,尼可地尔组治疗前后的变化值与对照组治疗前后的变化值比较ΔU-pro(127.04±254.17VS-42.65±198.38)mg/d、ΔHSCRP(1.73±2.47VS0.37±1.83)mg/L和ΔIL6(12.08±17.16VS-11.19±26.64)ng/L均显著降低(P﹤0.05),且尿蛋白的减少量(ΔU-pro)与HSCRP和IL6的变化值[ΔHSCRP(P﹤0.05)和ΔIL6(P﹤0.05)]呈线性相关,而两组间的Cr、Bun无显著改变(P﹥0.05)。结论尼可地尔可减轻高血压肾病的尿蛋白,该作用可能通过降低炎症因子HSCRP、IL6的水平而实现。
Objective To investigate the therapeutic effect of nicorandil on urinary protein in hypertensive nephropathy patients with normal blood pressure and its relationship with HSCRP and IL6. Methods Fifty-two patients with hypertensive nephropathy with normal blood pressure control were randomly divided into control group (n = 26) and nicorandil group (n = 26). Nicorandil (10 mg / day) or placebo (HSCRP), interleukin 6 (IL6), 24h urinary protein (U-pro), creatinine (Cr) and blood urea nitrogen (Bun) Results The changes of ΔU-pro (127.04 ± 254.17vs-42.65 ± 198.38) mg / d, ΔHSCRP (1.73 ± 2.47vs.37) in the Nicorandil group before and after treatment for 3 months were significantly higher than those in the control group ± 1.83) mg / L and ΔIL6 (12.08 ± 17.16 VS-11.19 ± 26.64) ng / L, respectively (P <0.05) and the decrease of urinary protein (ΔU-pro) and the change of HSCRP and IL6 [ΔHSCRP (P <0.05) and ΔIL6 (P <0.05)]. There was no significant change in Cr and Bun between the two groups (P> 0.05). Conclusions Nicorandil can reduce urinary protein in hypertensive nephropathy, and this effect may be achieved by reducing the levels of inflammatory factors HSCRP and IL6.