培哚普利和苯磺酸氨氯地平联合应用对高血压蛋白尿的作用

Effect of amlodipine combined with perindopril in patients with hypertension and microalbuminuria

目的观察培哚普利和苯磺酸氨氯地平联合应用治疗高血压蛋白尿的临床疗效。方法将136例高血压合并肾脏损害蛋白尿的患者随机分为A、B两组,A组给予培哚普利4mg/d和苯磺酸氨氯地平5mg/d,B组给予苯磺酸氨氯地平5mg/d和氢氯噻嗪12.5mg/d,均治疗26周。两组治疗前及治疗后测血压、尿白蛋白、尿素氮(BUN)、血肌酐(Scr),并计算肌酐清除率(Ccr)和不良反应。结果两组治疗后6.5个月,血压较前明显下降(P<0.01),两组下降值比较差异无统计学意义(P>0.05)。两组治疗后尿蛋白均下降(P<0.05),A组降低尿蛋白作用比B组更显著(P<0.01)。A组降低Scr、BUN更显著(P<0.05)。结论培哚普利和氨氯地平联合应用能明显较平稳降低高血压,显著减少尿蛋白,有效保护肾功能。

Objective To examine the effects of amlodipine （Amlo） combined with perindopril （peri） used in patients with hypertension and microalbuminuria. Methods One hundi, ed and thirty - six cases in patients with hypertension and microalbuminutia were divided randomly into two groups ： group A ： amlodipine 5 mg/d ＋ perindopril 4 rag/d, n = 68 ; group B ： amlodipine 5 mg/d ＋ 12.5 rag/d, n = 68. Treatment lasted for 26 weeks, parameter of blood pressurel （BP） ,24 h urinary albumin urine protein, blood urea nitrogen, serum creatinine, were measured before and after treatment. Results After treatment 6.5 months, both of two groups reduced blood pressure and proteinuria efficiently. In contrast, the reduction Scr and BUN were reduced more significantly in group A than in group B （ P 〈 0.01 ）. Conclusion The therapy of amlodipine combination contrast,the reduction in proteinuria can reduce in proteinuria is greater with perindopril in treating bypertentsive nephropathy with proteinuria can reduce blood pressure markly, produce a better ati - proteinuria effect, and have a better protection of renal function.