左旋氨氯地平联合缬沙坦治疗原发性高血压临床观察

EFFECT OF L-AMLODIPINE COMBINED VALSARTAN ON ESSENTIAL HYPERTENSION

目的探讨缬沙坦和左旋氨氯地平单独和联合应用治疗高血压的降压效果及对肾功能的保护作用。方法90例原发性高血压伴微量清蛋白尿患者随机分为缬沙坦治疗组、左旋氨氯地平治疗组和联合治疗组各30例,3组分别给予缬沙坦80mg,左旋氨氯地平2.5mg,缬沙坦80mg+左旋氨氯地平2.5mg,口服,1/d,若2周后血压未降至正常,则缬沙坦增至160mg,左旋氨氯地平增至5mg。疗程均为24周。观察治疗前后血压和肾功能变化。结果3组患者血压均明显下降(均P<0.01),尿微量清蛋白、β2微球蛋白均显著降低(P<0.01)。联合用药组降压和降尿蛋白作用优于二单独用药组(均P<0.01)。结论缬沙坦、左旋氨氯地平治疗原发性高血压均有较好的降压作用,且能降低微量清蛋白和微球蛋白,降低新发肾功能损害,两药联合应用可起到协同作用,更有效地降低血压,改善早期肾功能损害指标。

Objective To observe the effect of valsartan and L- Amtodipine alone or eombined on patients with essential hypertension, and its protective effect on renal function. Methods A total of 90 patients with essential hypertension concomitant with microalbuminuria were randomly divided into three group. The first group of 30 Patients were treated with valsartan （80mg, qd,po）, the second group were treated with L- Amlodipine （2.5rag, qd, po）, the third group were treated with Valsartan （80mg, qd,po） combined with L- Amlodipine （2.5mg, qd, po ）. After 2 weeks, if the blood pressure were not reduced to normal, then the dosage of valsartan was increased to 160mg. L- Amlodipine did to 5 mg. A course of treatment was 24 weeks, the clinical curative effect on change of blood pressure and renal function was observed. Results Blood pressure of the three groups were significantly decreased （P〈0.01）, urinary micro albumin and rnicroglobulin beta 2 were significantly decreased （P〈0.01） after treatment. The effect of decreasing blood pressure and proteinuria was better in the combination group than that in other two alone groups （P〈0.01）. Conclusion Treatment in essential hypertension with valsartan and L- Amlodipine seperately is effective, they can also reduce microalbuminuria and microglobulin, and reduce newonset renal dysfunction. Combined application of valsartan with L- Amlodipine has a synergistic effect, it can reduce blood pressure effectively and early renal injury.