苯那普利和氨氯地平对高血压病患者蛋白尿及肾功能的作用

Effects of Benazepril and Amlodipine on Proteinuria and Kidney Function in Hypertensive Patients

观察比较苯那普利和氨氯地平对高血压患者白蛋白尿及肾功能的疗效。方法：３０例未曾治疗的 高血压病患者随机分为两组，Ｉ组患者先服用苯那普利每日 １０ ｍｇ治疗 １２周，后用氨氯地平每日 １０ ｍｇ治疗 １２ 周。 Ⅱ组患者先服用氨氯地平每日 １０ ｍｇ治疗 １２周，后用苯那普利每日 １０ ｍｇ治疗 １２周。结果：两类药物能同等 程度地降低患者的动脉血压，两组患者在苯那普利治疗期间白蛋白尿均显著减少（Ｐ＜０．０１），而氨氯地平对白蛋白 尿无明显影响。结论：苯那普利改善蛋白尿作用不依赖于动脉血压的有效降低，其可能机制是肾内血流量或肾小 球通透性的改变所致。

Objective:To investigate the effects of benazepril and amlodipine on urinary albumin excretion and kidney function. Methods:30 previotaly untreated patients with essential hypertension were divided randomly into two groups. The first group(n = 15)received bemazepril 10 mg daily for 12 weeks followed by amlodipine 10 mg daily for 12 weeks. The second group(n = 15)received amlodipine 10 mg daily for 12 weeks followed by benazepril 10 mg drily for 12 weeks. Results:The arterial pressure decreased in a similar way with both therapies in both groups. In both groups urinary albumin excretion decreased in patients receiving benazepril(P< 0. 01). No significant changes were observed with amlodipine. Conclusion : The benefit of benazepril on proteinuria was independent of its effective antihypertensive properties. It was probable that the pos- itive effect of benazepril on proteinuria was due to the modification of intrarenal circulation or the improvement of glomerular permeability.