缬沙坦联合氢氯噻嗪治疗慢性肾脏病合并肾性高血压的临床观察

Clinical Observation of Valsartan Combined with Hydrochlorothiazide in the Treatment of Chronic Renal Disease Complicated with Hypertension

目的:观察缬沙坦联合氢氯噻嗪治疗慢性肾脏病合并肾性高血压的临床疗效和安全性。方法:156例慢性肾脏病合并肾性高血压患者随机分为对照组和观察组,每组78例。对照组患者给予氢氯噻嗪片25 mg,口服,每日1次,观察组患者在对照组治疗基础上加服缬沙坦胶囊80 mg,每日1次。两组疗程均为4周。观察并比较两组患者临床疗效,治疗前后收缩压(SBP)、舒张压(DBP)、肾小球滤过率(GFR)、24 h尿蛋白定量、血肌肝(Scr)、血尿素氮(BUN)水平及不良反应发生情况。结果:观察组患者临床总有效率显著高于对照组,差异有统计学意义(85.90%vs.64.10%,P<0.05)。治疗前,两组患者SBP、DBP、GFR、24 h尿蛋白定量、Scr及BUN比较,差异均无统计学意义(P>0.05)。治疗后,两组患者SBP、DBP、24 h尿蛋白定量、Scr及BUN水平显著低于同组治疗前,且观察组显著低于对照组,GFR显著高于同组治疗前,且观察组显著高于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:缬沙坦联合氢氯噻嗪治疗慢性肾脏病合并肾性高血压疗效较好,可以显著改善患者血压和肾功能,安全性亦较好。

OBJECTIVE： To observe clinical efficacy and safety of valsartan combined with hydrochlorothiazide in the treat- ment of chronic renal disease complicated with hypertension. METHODS： A total of 156 chronic kidney disease patients with renal hypertensive were randomly divided into control group and observation group with 78 cases in each group. Control group was given hydrochlorothiazide tablets 25 mg orally, once a day. Observation group was additionally given valsartan capsule 80 mg orally, once a day, on the basis of control group. Treatment course of 2 groups lasted for 4 weeks. Clinical efficacies of 2 groups were observed and compared, and the levels of SBP, DBP, GFR, 24 h urine protein quantification, Scr and BUN were observed before and after treatment. The occurrence of ADR was recorded. RESULTS： After treatment, total response rate of observation group was signifi- cantly higher than that of control group, with statistical significance （85.90% vs. 64.10%, P〈0.05）. Before treatment, there was no statistical significance in SBP, DBP, GFR, 24 h urine protein quantification, Scr and BUN between 2 groups （P〉0.05）. After treatment, SBP, DBP, 24 h urine protein quantification, Scr and BUN of 2 groups were significantly lower than before treatment, the observation group was significantly lower than the control group, GFR was significantly higher than before treatment, the observa- tion group was significantly higher than that of control group, with statistical significance （P〈0.05）. There was no statistical signif- icance in the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： Valsartan combined with hydrochlorothiazide show good therapeutic efficacy for chronic renal disease complicated with hypertension, and can significantly improve blood pressure and renal function with good safety.