缬沙坦对70岁以上高血压患者合并蛋白尿疗效观察

Observation of therapeutic effect of valsartan on hypertension complicated albuminuria in patients aged seventy years old and over

目的观察不同降压药物对≥70岁高血压患者合并蛋白尿的治疗效果。方法 78例≥70岁高血压合并蛋白尿患者,停用原用药1周,血压明显增高者,临时加用短效利尿剂,随机均分为2组。A组口服硝苯地平缓释片10mg,每天2次;B组口服缬沙坦胶囊80mg,每天1次。疗程12周,每天监测血压2次,并记录出现的不良反应。用药前后测尿微量白蛋白(MAU),血、尿β2微球蛋白,血肌酐、血常规和肝功能。结果治疗12周后2组血压均下降,总有效率无显著差异。B组尿微量白蛋白和血、尿β2微球蛋白浓度均显著下降(P<0.05),A组尿微量白蛋白,血、尿β2微球蛋白无明显下降,2组间有显著性差异(P<0.01)。结论缬沙坦在有效降血压的同时,可显著降低尿中微量白蛋白及血、尿β2微球蛋白。

Objective To observe the therapeutic effect of different hypotensive drug on hypertension complicated with albuminuria in elderly patients aged seventy years old and over.Methods A total of 78 elderly patients with primary hypertension complicated with albuminuria who had stopped taking the original anti-hypertension drug for one week were enrolled in the study.They were randomly divided into two groups：Group A（n=39）,treated with nifedipine 10 mg,twice a day;group B（n=39）,treated with valsartan 80 mg/d.Adverse effect and blood pressure were recorded.The levels of uric micro albuminuria,uric β2 micro globulin,blood β2 micro globulin,serum creatinine,and blood routine and hepatic function were measured before and after the treatment.Results The blood pressures of the two groups decreased after 12 weeks’ treatment.There was no significant difference in total effective rate between the two groups （P〉0.05）.There were significant differences in the levels of uric micro albuminuria,uric β2 micro globulin and blood β2 micro globulin between the two groups（P〈0.01）.Conclusions Valsartan not only decreases blood pressure,but also significantly reduces the levels of uric micro albuminuria,uric β2micro globulin and blood β2 micro globulin.