Background Studies have confirmed that angiotensin II receptor blocker （ARB） and angiotensin converting enzyme inhibitors （ACEI） in the treatment of diabetic nephropathy （DN） has special advantages. We observed ...Background Studies have confirmed that angiotensin II receptor blocker （ARB） and angiotensin converting enzyme inhibitors （ACEI） in the treatment of diabetic nephropathy （DN） has special advantages. We observed the effects of valsartan and metoprolol tartrate hydrchloride in treatment of DN patients with positive β1-adrenergic and anti-angiotensin II type 1 （AT1） receptor antibody. Methods The epitopes of the second extracellular loop of β1 receptor （197-222） and AT1 receptor （165-191）, were synthesized and used respectively to screen serum autoantibodies from patients with DN （n=371, group A）, diabetes mellitus （DM） without renal failure （n=107, group B） and healthy blood donors （n=47, control, group C） by enzyme-linked immunosorbent assay （ELISA）. Metoprolol tartrate 25-50 mg, three times per day, valsartan 160 mg, once a day, aspirin 100 rag, once a day, and nitrendipine 10-20 mg, three times per day, were given to DN patients with positive or negative autoantibodies. The cystatin C level and 24-hour urinary protein were measured before and after treatment. Results In DN patients, the positive rate of the autoantibodies against β1 receptors and AT1 receptor was 47.7% and 51.5%, respectively, which were significantly higher than those in DM patients and healthy controls （all P 〈0.01）. Patients with anormalous cystatin C had higher positive rates of the autoantibodies than patients with normal cystatin C. Valsartan and metoprolol tartrate reduced proteinuria significantly （P 〈0.01） in DN patients with positive autoantibodies. Conclusions The findings suggest that these autoantibodies against β1 and ATl-receptor may play important roles in the pathogenesis of DN. Valsartan and metoDrolol tartrate are effective and safe in the treatment of DN.展开更多
目的探讨缬沙坦联合酒石酸美托洛尔治疗原发性高血压并冠心病的临床效果。方法 84例原发性高血压并冠心病患者,随机分为研究组和对照组,各42例。对照组使用硝苯地平缓释片口服治疗,研究组使用缬沙坦联合酒石酸美托洛尔治疗。比较两组患...目的探讨缬沙坦联合酒石酸美托洛尔治疗原发性高血压并冠心病的临床效果。方法 84例原发性高血压并冠心病患者,随机分为研究组和对照组,各42例。对照组使用硝苯地平缓释片口服治疗,研究组使用缬沙坦联合酒石酸美托洛尔治疗。比较两组患者治疗前后的血压水平、心绞痛症状改善情况和生活质量评分。结果治疗4周后,研究组的收缩压、舒张压分别为(131.61±11.30)、(75.63±9.24)mm Hg(1 mm Hg=0.133 k Pa),均低于对照组的(147.27±13.45)、(87.14±9.61)mm Hg,差异均具有统计学意义(P<0.05);研究组心绞痛症状改善总有效率为88.1%,高于对照组的69.0%,差异具有统计学意义(P<0.05);治疗后研究组SF-36量表各项指标评分均优于对照组,差异均具有统计学意义(P<0.05)。结论缬沙坦联合酒石酸美托洛尔能有效控制原发性高血压并冠心病患者的血压水平,降低心绞痛发生率,提高生活质量,值得临床推广。展开更多
基金This study was supported by a grant from the Natural Science Foundation of Hubei Province （No. 2002AB 116）.
文摘Background Studies have confirmed that angiotensin II receptor blocker （ARB） and angiotensin converting enzyme inhibitors （ACEI） in the treatment of diabetic nephropathy （DN） has special advantages. We observed the effects of valsartan and metoprolol tartrate hydrchloride in treatment of DN patients with positive β1-adrenergic and anti-angiotensin II type 1 （AT1） receptor antibody. Methods The epitopes of the second extracellular loop of β1 receptor （197-222） and AT1 receptor （165-191）, were synthesized and used respectively to screen serum autoantibodies from patients with DN （n=371, group A）, diabetes mellitus （DM） without renal failure （n=107, group B） and healthy blood donors （n=47, control, group C） by enzyme-linked immunosorbent assay （ELISA）. Metoprolol tartrate 25-50 mg, three times per day, valsartan 160 mg, once a day, aspirin 100 rag, once a day, and nitrendipine 10-20 mg, three times per day, were given to DN patients with positive or negative autoantibodies. The cystatin C level and 24-hour urinary protein were measured before and after treatment. Results In DN patients, the positive rate of the autoantibodies against β1 receptors and AT1 receptor was 47.7% and 51.5%, respectively, which were significantly higher than those in DM patients and healthy controls （all P 〈0.01）. Patients with anormalous cystatin C had higher positive rates of the autoantibodies than patients with normal cystatin C. Valsartan and metoprolol tartrate reduced proteinuria significantly （P 〈0.01） in DN patients with positive autoantibodies. Conclusions The findings suggest that these autoantibodies against β1 and ATl-receptor may play important roles in the pathogenesis of DN. Valsartan and metoDrolol tartrate are effective and safe in the treatment of DN.
文摘目的探讨缬沙坦联合酒石酸美托洛尔治疗原发性高血压并冠心病的临床效果。方法 84例原发性高血压并冠心病患者,随机分为研究组和对照组,各42例。对照组使用硝苯地平缓释片口服治疗,研究组使用缬沙坦联合酒石酸美托洛尔治疗。比较两组患者治疗前后的血压水平、心绞痛症状改善情况和生活质量评分。结果治疗4周后,研究组的收缩压、舒张压分别为(131.61±11.30)、(75.63±9.24)mm Hg(1 mm Hg=0.133 k Pa),均低于对照组的(147.27±13.45)、(87.14±9.61)mm Hg,差异均具有统计学意义(P<0.05);研究组心绞痛症状改善总有效率为88.1%,高于对照组的69.0%,差异具有统计学意义(P<0.05);治疗后研究组SF-36量表各项指标评分均优于对照组,差异均具有统计学意义(P<0.05)。结论缬沙坦联合酒石酸美托洛尔能有效控制原发性高血压并冠心病患者的血压水平,降低心绞痛发生率,提高生活质量,值得临床推广。
