苯磺酸左旋氨氯地平联合依那普利对原发性高血压患者尿微量白蛋白的影响

The impact of Levamlodipine combined with Enalapril on urine microalbuminuria in patients with essential hypertension

目的观察苯磺酸左旋氨氯地平与依那普利联合治疗原发性高血压的疗效及对尿微量白蛋白的影响。方法 90例原发性高血压伴微量蛋白尿门诊或住院患者,按就诊顺序随机分成3组:口服磺酸左旋氨氯地平2.5～5mg.d-1(A组,30例);口服依那普利10～20mg.d-1(B组,30例);口服苯磺酸左旋氨氯地平+依那普利2.5～5mg.d-1+10～20mg.d-1(C组,30例);疗程共24周。比较3组治疗前及治疗后2周、4周、12周、24周血压下降水平,同时测定尿微量白蛋白、血清尿素氮和肌酐。结果与治疗前相比,3组在治疗2周后血压均开始下降,C组降压疗效与A组、B组比较差异有统计学意义(P<0.05);3组在治疗4周后尿微量白蛋白均有所下降,其中C组明显降低(P<0.01),并随着用药时间的延长,C组尿微量白蛋白不断降低,24周后明显低于A组、B组(P<0.01)。结论苯磺酸左旋氨氯地平联合依那普利有良好的降压效果,并且能降低尿微量白蛋白。

OBJECTIVE To explore the effect of Levamlodipine combined with Enalapril in patients with essential hypertension and the impact of urine microalbuminuria.METHODS 90 cases of essential hypertension with microalbuminuria outpatient or inpatient,According to the order of treatment were randomly divided into 3 groups：oral Levamlodipine 2.5～5mg·d-1（A group,30 cases）;oral enalapril 10～20mg·d-1（B group,30 cases）;oral Levamlodipine ＋ Enalapril 2.5～5mg·d-1＋10～20mg·d-1（C group,30 cases）;a total of 24 weeks treatment.Comparing pretherapy with post-treatment 2 weeks,4 weeks,12 weeks,24 weeks in decreasing blood pressure levels of three treatment groups.Microalbuminuria,serum nitrogen and creatinine were examined at the same time.RESULTS Both SBP and DBP were significantly decreased in three groups after two weeks,these changes in C group were more significant than A group or B group（P〈0.05）;After 4-week treatment,microalbuminuria was decreased in three groups,especially in the C group（P〈0.01）.With the time of medication in combined treatment group,microalbuminuria was increasingly decreased which was more significant than A group or B group after 24 weeks（P〈0.01）.CONCLUSION The levamlodipine with enalapril are more effective in lowering blood pressure,and decreasing microalbuminuria.