赖诺普利和氨氯地平对原发性高血压微量白蛋白尿的影响

Effect of Lisinopril and Amlodipine on Microalbuminuria in Patients with Essential Hypertension

目的评估钙通道阻滞剂氨氯地平及血管紧张素转换酶抑制剂赖诺普利对原发性高血压微量白蛋白尿的影响。方法筛选了324例原发性高血压患者微量白蛋白尿,记录了120例。将120例患者随机分为两组,各60例,两组患者年龄、性别、血压、肌酐清除率、尿微量白蛋白排泄率等具有均衡性,分别给予氨氯地平或赖诺普利,测定氨氯地平或赖诺普利治疗前后及第4周和第8周尿白蛋白排泄率和肌酐清除率。结果平均动脉压治疗前及治疗后第4周和第8周的变化,氨氯地平组为(113.01±4.38)mmHg,(104.93±3.12)mmHg和(98.89±1.75)mmHg,差异有统计学意义(P<0.0000);赖诺普利组为(114.13±7.11),(106.52±3.50)和(100.89±2.80)mmHg,差异有统计学意义(P<0.0000),尿白蛋白排泄量治疗前及治疗后第4周和第8周的变化,赖诺普利组为(79.30±3.74),(62.03±3.61)和(52.02±3.05),差异有统计学意义(P<0.0001),氨氯地平组为(73.96±4.10),(72.39±3.74)和(66.12±3.94),差异无统计学意义(P>0.05)。结论赖诺普利显著减少微量白蛋白尿,尽管两者的降压疗效相似。

Objective Evaluate the effect of a commonly used calcium channel blocker,amlodipine,and an angiotensin converting enzyme inhibitor,lisinopril on urinary albumin excretion in patients with essential hypertension.Methods Screened 324 patients with essential hypertension for microalbuminuria and documented it in 120 patients.These 120 patients with microalbuminuria were randomly divided into two groups of 60 each,matched for age,sex,arterial pressure,creatinine clearance,and urinary albumin excretion so as to receive amlodipine or lisinopril.Prospectively measured their urinary albumin excretion and creatinine clearance prior to treatment and,four and eight weeks after treatment with amlodipine or lisinopril.Mean arterial pressure （mean±SD） at baseline.Results After four weeks,and after eight weeks was （113.01±4.38）,（104.93±3.12） and （98.89±1.75） mm Hg ,the differences were all statistical（P〈0.0000）; and（ 114.13±7.11）,（106.52±3.50）and（100.89±2.80）mm Hg,the differences were all statistical（P〈0.0000） in amlodipine and lisinopril groups,respectively.Urinary albumin excretion at baseline,after four,and after eight weeks was （79.30 ± 3.74）,（ 62.03 ± 3.61）and（ 52.02 ± 3.05）,the differences were all statistical（P〈0.0001）; and （73.96 ± 4.10）,（ 72.39 ± 3.74）,（ 66.12 ± 3.94）,the difference was not statistical （P〉0.05）,in lisinopril and amlodipine groups,respectively.Conclusion Methods Conclusions Lisinopril reduced the urinary albumin excretion significantly despite their similar antihypertensive efficacy.