贝那普利与缬沙坦联合治疗肾性高血压的临床疗效及对肾功能的影响

Therapeutic effect of benazepril combined valsartan on renal hypertension and its influence on renal function

目的：探讨贝那普利与缬沙坦联合治疗肾性高血压的疗效及对肾功能的影响。方法：选择2013年3月~2016年1月我院收治的肾性高血压患者192例,采用随机数字表法均分为贝那普利组、缬沙坦组、联合治疗组（联合使用贝那普利和缬沙坦）。对比分析3组患者治疗前后血压及肾功能情况,以及不良反应发生情况。结果：与治疗前比较,三组治疗后收缩压（SBP）、舒张压（DBP）、24h尿蛋白排泄量（24hUPE）和血肌酐（Scr）水平均有显著降低（P均〈0.01）;与贝那普利组比较,缬沙坦组、联合治疗组治疗后SBP[（146.7±7.2）mmHg比（133.8±6.7）mmHg比（110.4±6.2）mmHg]、DBP[（85.3±5.7）mmHg比（82.1±5.5）mmHg比（74.8±5.3）mmHg]、24hUPE[（1.46±0.43）g/d比（1.29±0.51）g/d比（1.06±0.25）g/d]和Scr[（190.3±9.8）μmol/L比（185.4±9.7）μmol/L比（174.4±9.1）μmol/L]水平降低更显著,且联合治疗组上述指标均显著低于缬沙坦组,P〈0.05或〈0.01。贝那普利组、缬沙坦组和联合治疗组间不良反应发生率（12.50%比10.94%比9.38%）无显著差异,P〉0.05。结论：贝那普利联合缬沙坦可有效改善肾性高血压患者血压及肾功能水平,安全有效,适合临床推广。

Objective：To explore therapeutic effect of benazepril combined valsartan on renal hypertension and its influence on renal function.Methods：A total of 192 patients with renal hypertension treated in our hospital from Mar2013 to Jan 2016 were selected.According to random number table,they were randomly and equally divided into benazepril group,valsartan group and combined treatment group（received benazepril combined valsartan）.Blood pressure and renal function before and after treatment,and incidence of adverse reactions were compared and analyzed among three groups.Results：Compared with before treatment,there were significant reductions in levels of systolic blood pressure（SBP）,diastolic blood pressure（DBP）,24 hurinary protein excretion（24hUPE）and serum creatinine（Scr）in three groups after treatment（P〈0.01all）;compared with benazepril group after treatment,there were significant reductions in levels of SBP[（146.7±7.2）mmHg vs.（133.8±6.7）mmHg vs.（110.4±6.2）mmHg],DBP [（85.3±5.7）mmHg vs.（82.1±5.5）mmHg vs.（74.8±5.3）mmHg],24 hUPE [（1.46±0.43）g/d vs.（1.29±0.51）g/d vs.（1.06±0.25）g/d]and Scr[（190.3±9.8）μmol/L vs.（185.4±9.7）μmol/L vs.（174.4±9.1）μmol/L]in valsartan group and combined treatment group,and those of combined treatment group were significantly lower than those of valsartan group,P〈0.05or0.01.There was no significant difference in incidence of adverse reactions（12.50% vs.10.94% vs.9.38%）among benazepril group,valsartan group and combined treatment group,P〈0.05.Conclusion：Benazepril combined valsartan can effectively improve blood pressure level and renal function in patients with renal hypertension.It′s safe and effective,which is worth extending.