贝那普利和氯沙坦联合治疗肾实质性高血压45例疗效与安全性观察

Efficacy and safety of benazepril combined losartan in treatment of renal parenchymal hypertension:45 cases report

目的观察贝那普利和氯沙坦联合治疗肾实质性高血压的疗效与安全性。方法选择我院2014年1月~2015年3月肾实质性高血压患者89例,采用隐藏数字随机法分为两组,对照组44例给予氯沙坦治疗,研究组45例给予贝那普利和氯沙坦联合治疗,治疗前和治疗后3个月检测血压、血肌酐（SCr）、尿素氮（BUN）、24h尿蛋白（24Hup）等,记录用药期间不良反应。结果治疗后两组收缩压（SBP）、舒张压（DBP）较治疗前显著下降,研究组治疗后SCr、BUN、24Hup较治疗前降低（P〈0.05）。对照组治疗后BUN无明显降低（P〉0.05）,SCr、24Hup较治疗前降低（P〈0.05）。研究组治疗后SBP、DBP降低幅度大于对照组（P〈0.05）,24Hup降低幅度大于对照组（P〈0.05）。研究组不良反应发生率为6.67%,对照组不良反应发生率为4.55%,两组比较差异无统计学意义（χ~2=0.000,P=1.000）。结论贝那普利和氯沙坦联合治疗肾实质性高血压降压效果好,还可降低尿蛋白,而且安全性好。

Objective To observe the efficacy and safety of benazepril combined with losartan in treatmentof renal parenchymal hypertension. Methods Eighty-nine patients with renal parenchymal hypertensioncared at our hospital from January 2014 to March 2015 were divided into two groups by using a hidden random number method. The control group （44 cases） was treated with losartan. The study group received （45 cases） benazepril combined with losartan. Blood pressure, serum creatinine （SCr）, blood urea nitrogen （BUN）, uric acid and 24h urine protein （24Hup） were measured before treatment and 3 months after treatment. The adverse reactions were recorded. Results After treatment, DBP and SBP in the two groups were significantlylower than those before treatment. After treatment, BUN, 24Hup and SCr in the study group were lower than those before treatment, comparison showed statistical difference （ P d0.05）. In the control group, there was no significant decrease in BUN after treatment （ P 〉0.05）, and 24Hup and SCr were lower than those before treatment （ P 〈0.05）. The reduction of SBP and DBP in the study group was significantly higher than those in the control group （ P 〈0. 05）, and the decrease of 24Hup was significantly higher than that in the control group （ P 〈0.05）. The adverse reaction rate was 6.67% in the study group and 4.55% in the control group,comparison yielded no statistical difference （χ2=0. 000, P= 1. 000）. Conclusion Benazepril combined withlosartan in the treatment of renal parenchymal hypertension has good effect on lowering blood pressure, can also reduce urine protein, and the safety is good.