缬沙坦联合氨氯地平治疗慢性肾脏病合并肾性高血压的效果

Effect of valsartan combined with amlodipine in the treatment of chronic kidney disease complicated with renal hypertension

目的探讨缬沙坦联合氨氯地平治疗慢性肾脏病合并肾性高血压的疗效及安全性。方法选取2017年5月至2018年12月于我院进行治疗的慢性肾脏病合并肾性高血压患者,采用随机数字表法分为对照组(n=55)和观察组(n=55)。对照组行氨氯地平治疗方案,观察组行缬沙坦联合氨氯地平治疗方案。比较两组患者治疗效果、血压变化、肾功能变化及药物安全性。结果观察组治疗总有效率为90.91%,高于对照组的72.73%(P<0.05)。两组治疗前SBP和DBP比较,差异无统计学意义(P>0.05);两组治疗后SBP和DBP均下降(P<0.05),且观察组SBP和DBP下降程度更为显著(P<0.05)。两组治疗前肾功能指标比较,差异无统计学意义(P>0.05);两组治疗后GFR、24 h尿蛋白定量、Scr、BUN水平均改善(P<0.05),且观察组改善程度更显著(P<0.05)。两组患者治疗期间无严重不良反应发生,药物治疗安全性高。结论慢性肾脏病合并肾性高血压患者行缬沙坦联合氨氯地平治疗,能有效改善患者血压及肾功能,药物安全性高,具有进一步探讨的临床意义。

Objective To investigate the efficacy and safety of valsartan combined with amlodipine in the treatment of patients with chronic kidney disease complicated with renal hypertension.Methods Patients with chronic kidney disease complicated with renal hypertension who were treated in our hospital from May 2017 to December 2018 were selected and divided into the observation group(n=55)and the control group(n=55)according to the random number table method.The control group was treated with amlodipine,while the observation group was treated with valsartan combined with amlodipine.The therapeutic effect,changes in blood pressure,renal function and drug safety were compared between the two groups.Results The total effective rate of 90.91%in the observation group was higher than 72.73%in the control group(P<0.05).Before treatment,there was no significant difference in SBP and DBP between the two groups(P>0.05).After treatment,SBP and DBP decreased in both group(P<0.05),and the decrease degree of SBP and DBP in the observation group was more significant(P<0.05).Before treatment,there was no significant difference in renal function indexes between the two groups(P>0.05).After treatment,the level of GFR,24-hour urinary protein quantity,Scr,BUN and other indexes were improved in both groups(P<0.05),more significantly in the observation group(P<0.05).No serious adverse reactions occurred during the treatment in the two groups,and the drug was very safe for the treatment.Conclusion Valsartan combined with amlodipine for the treatment of patients with chronic kidney disease complicated with renal hypertension can effectively improve the blood pressure and renal function,and with good drug safety,which has clinical significance for further discussion.