贝那普利联合氯沙坦对高血压合并糖尿病患者动态血压的影响及肾脏的保护作用

目的探讨贝那普利联合氯沙坦对高血压合并糖尿病患者的降压效果和对肾脏的保护作用。方法选取原发性高血压合并糖尿病患者96例,随机分为3组(n=32)。分别予贝那普利、氯沙坦、贝那普利+氯沙坦治疗,疗程3个月。检测治疗前及治疗后1、3个月时患者24 h动态血压及尿微量蛋白排泄率。结果 (1)治疗后3组患者24 h平均收缩压和平均舒张压均显著低于治疗前,差异有统计学意义(P<0.05);联合组治疗后平均舒张压与单独用药组比较,差异有统计学意义(P<0.05);平均收缩压比较,差异无统计学意义;治疗后2个单独用药组平均舒张压和收缩压比较,差异无统计学意义;(2)3组治疗1、3个月后患者尿微量蛋白水平较治疗前均显著降低,差异有统计学意义(P<0.05);联合用药组患者尿微量蛋白水平下降幅度显著高于单独用药组,差异有统计学意义(P<0.05);2个单独用药组尿微量蛋白下降幅度比较,差异无统计学意义;(3)3组患者治疗期间均未见严重不良反应。结论贝那普利与氯沙坦联合应用可在很大程度上阻断肾素-血管紧张素系统,降低血压效果优于单一应用贝那普利与氯沙坦的患者,同时表现出强大的肾脏保护作用。

Objective To discuss clinical efficacy on dynamic blood pressure and renal protection of Benner Pury combined with losartan in treatment of patients with primary hypertension and type 2 diabetes. Methods 96 admitted cases with class Ⅰ-Ⅱ primary hypertension were randomly divided into 3 groups,each group was given treatment of Benner Pury, losartan, Benner Pury ＋losartan for 3 months respectively, after which 24 h dynamic blood pressure and urinary albumin excretion rate （UAER） were measured and compared between pretreatment and 1 months ＆ 3 months after treatment. Results （ 1 ）After treatment, patients＇ 24 h average systolic ＆ diastolic pressure of 3 groups were significantly lower than pretreatment （P〈0.05）, combination group after treatment whose diastolic pressure was significantly lower than the other single drug group （P〈0.05）,and average systolic blood pressure of 3 groups with no significant difference, and average diastolic ＆systolic pressure of 2 single groups after treatment had no significant difference; （2）UAER of 3 groups after treatment for 1 month and 3 months were significantly decreased （P〈0.05）,UAER of combination group decreased more significantly than the other 2 single drug groups（P〈0.05）, and UAER of 2 single drug groups after treatment had no statistical significance; （3）There were no serious adverse drug reactions during treatment. Conclusion Combined application of Benner Pury and losartan can block the renin-angiotensin system to a great extent, blood pressure reducing effect is better than the single application ofBenner Pury or losartan,while exhibiting potent renoprotective effects.