目的 研究苯磺酸氨氯地平联合贝那普利对腹膜透析患者血压及血压晨峰(MBPS)的影响.方法 155例高血压肾病或肾性高血压腹膜透析患者经过2周安慰剂导入期筛选出135例,随机分为2组,治疗组75例给予苯磺酸氨氯地平和贝那普利口服;对照组60例给予硝苯地平缓释片和贝那普利口服,治疗12周后随访血压12周,每2周随访1次,观察2组24h 动态血压(ABP) 的平均SBP(MSBP)、平均DBP(MDBP),白昼SBP、DBP,夜间SBP 、DBP和MBPS阳性率变化.结果 2组治疗后MSBP、MDBP均较治疗前明显下降(P＜0.01),治疗组降低幅度较对照组明显(P＜0.01);2组治疗后白昼和夜间的SBP、DBP均显著降低(P＜0.01),治疗组降低幅度比对照组降低幅度大(P＜0.01);对照组治疗后MBPS阳性率为43.0%,治疗组为22.5%,2组比较差异有统计学意义(P＜0.01).结论 苯磺酸氨氯地平联合贝那普利可降低高血压肾病或肾性高血压腹膜透析患者的SBP、DBP 和MBPS.%Objective To observe the therapeutic effect of amlodipine besylate combination with benazepril on blood pressure and morning blood pressure surge( MBPS )in peritoneal dialysis patients. Methods Totally 135 cases peritoneal dialysis patients with hypertension were divided into two groups, the treatment group ( 75 cases ) and control group ( 60 cases ). The treatment group was treated with amlodipine besylate and benazepril, while the control group was treated with nifedipine sustained release tablets and benazepril. After treatment for 12 weeks, follow up were carried out for 12 weeks with once every 2 weeks. The MSBP,MDBP, the night and day time SBP, DBP and the positive ratio of MBPS of 24h, and ABP of the two groups before and after treatment were compared. Results After treatment, the MSBP and MDBP surge of the two groups were significantly decreased( P < 0. 01 ), and the treatment group decreased significantly than that of the control group( P < 0.01 ); the night and day time SBP and DBP of the two groups were significantly decreased( P <0. 01 ), the treatment group decreased significantly than that of the control group after treatment P <0. 01 ); the positive ratio of MBPS in control group was 43.0% and treatment group was 22. 5% . There was significant difference between the two groups( P < 0. 01 ). Conclusion It demonstrated that the amlodipine besylate combined with benazepril could decrease the SBP, DBP and MBPS in the patients with hypertensive nephropathy of peritoneal dialysis.
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