Peng D-F, Tang S-Y, Hu Y-J, Chen J, Peng X, Huang Q
Department of Vasculocardiology, Affiliated Puai Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Eur Rev Med Pharmacol Sci. 2015 Apr;19(7):1264-71.
The aims to investigate the different protective effects of valsartan and benazepril when combined with atorvastatin in the cardio-renal functions of cardio-renal syndrome (CRS) patients.
A total of 200 early CRS patients were enrolled in the present study, including 104 males and 96 females, with an average age of 62.2 ± 7.7 years. The same group of patients were set as the control group prior to treatment, and then randomly divided into two groups; the A group was treated with valsartan (80 mg/d) and atorvastatin (20 mg/d); the B group was treated with benazepril (10 mg/d) and atorvastatin (20 mg/d). The treatment period was 24 months.
The clinical efficacy and clinical events were observed and the following parameters of each patient were measured before and after treatment: 24h urine protein; creatinine clearance; serum brain natriuretic peptide (BNP); high sensitivity C-reactive protein (hsCRP); blood lipid level; liver function and ejection fraction (EF) value. Compared with the control group, the clinical symptoms of the treatment groups were improved with decreased blood lipid levels, significantly decreased serum BNP and hsCRP levels and significantly increased EF values and creatinine clearance rates (p < 0.01). The differences between the two treatment groups were not statistically significant. The number of patients that stopped treatment due to the development of a cough was significantly higher in the B group than the A group (p < 0.01).
When combined with atorvastatin, both valsartan and benazepril effectively improved the cardio-renal functions of early CRS patients. There was no significant difference between the two treatments however, valsartan appeared to be better tolerated by patients.
探讨缬沙坦和苯那普利与阿托伐他汀联合应用时对心肾综合征（CRS）患者心肾功能的不同保护作用。
本研究共纳入200例早期CRS患者，其中男性104例，女性96例，平均年龄62.2±7.7岁。治疗前将同一组患者设为对照组，然后随机分为两组；A组接受缬沙坦（80mg/d）和阿托伐他汀（20mg/d）治疗；B组接受苯那普利（10mg/d）和阿托伐他汀（20mg/d）治疗。治疗期为24个月。
观察临床疗效和临床事件，并在治疗前后测量每位患者的以下参数：24小时尿蛋白；肌酐清除率；血清脑钠肽（BNP）；高敏C反应蛋白（hsCRP）；血脂水平；肝功能和射血分数（EF）值。与对照组相比，治疗组临床症状改善，血脂水平降低，血清BNP和hsCRP水平显著降低，EF值和肌酐清除率显著升高（p<0.01）。两个治疗组之间的差异无统计学意义。B组因咳嗽而停止治疗的患者数量显著高于A组（p<0.01）。
缬沙坦和苯那普利与阿托伐他汀联合应用时均能有效改善早期CRS患者的心肾功能。两种治疗方法之间无显著差异，然而，缬沙坦似乎更易被患者耐受。
