不同联合方案对维持性血液透析患者高血压的疗效分析

Efficacy analysis of different combination therapies in hypertension of the maintenance hemodialysis patients

目的:观察苯磺酸氨氯地平和缬沙坦联合对比苯磺酸氨氯地平和卡维地洛联合治疗维持性血液透析患者高血压的临床疗效,同时观察两组对血压、血肌酐、血尿素氮及24h尿蛋白定量的影响,以评价两组药物治疗高血压的效果及安全性。方法:从2009年1月～2010年l月收集住院及门诊维持性血液透析高血压患者66例,自主应用苯磺酸氨氯地平+缬沙坦(缬沙坦组)治疗或应用苯磺酸氨氯地平+卡维地洛(卡维地洛组),观察两组治疗高血压取得的疗效。结果:治疗8周及半年后,缬沙坦组、卡维地洛组的收缩压和舒张压较治疗前均有明显降低,差异有统计学意义(P<0.05),两组降压趋势相似,差异无统计学意义(P>0.05)。缬沙坦组患者服药后24h尿蛋白定量有所降低,与卡维地洛组相比,差异有统计学意义(P<0.05)。结论:两种治疗方案均能有效控制血压,且均对高血压患者肾功能无明显影响。苯磺酸氨氯地平+缬沙坦联合治疗可对蛋白尿有明显的减轻作用,说明其在治疗高血压的同时对肾脏有保护作用。

Objective： To observe the combined amlodipine and valsartan compared to amlodipine combination therapy of carvedilol peacefully maintenance hemodialysis patients with hypertension clinical efficacy, while observing the two pairs of blood pressure, serum creatinine, blood urea nitrogen and 24-hour urinary protein of the impact of the two groups of drug treatment of hypertension to evaluate the efficacy and safety. Methods： From January 2009 to January 2010 collected inpatient and out-patient on maintenance hemodialysis patients 66 cases of hypertension, self-application of amlodipine besylate ＋ valsartan （valsartan group） in the treatment or application of amlodipine horizon ＋ carvedilol （carvedilol group） were observed to obtain the efficacy of the treatment of hypertension. Results： After 8 weeks, valsartan group, carvedilol group were significantly lower systolic and diastolic blood pressure, the difference was statistically significant （P〈0.05）, two buck the trend was similar to the difference was not statistically significant （P〉0.05）. 24-hour urinary protein after taking valsartan patients both to reduce and the difference was statistically significant （P〈0.05）, carvedilol therapy before and after treatment were significant differences in serum uric acid （P〈0.05）. Conclusion： Two kinds of treatment programs can effectively control blood pressure, and both pairs of renal function in patients with essential hypertension had no significant effect. Amlodipine besylate ＋ valsartan combination therapy can significantly reduce the role of proteinuria, indicating the same time in the treatment of hypertension has a protective effect on the kidneys.