贝尼地平联合氯沙坦对原发性高血压合并微量蛋白尿患者的疗效及肾保护作用的临床研究

摘要

目的：探讨贝尼地平联合氯沙坦对原发性高血压合并微量蛋白尿患者的疗效及其对肾的保护。方法：选取本院住院及门诊诊断为原发性高血压合并微量蛋白尿患者116例，按照随机数字表法分为两组，服用氨氯地平和氯沙坦的58例为对照组，服用贝尼地平和氯沙坦的58例为观察组。治疗前后均测量血压，检测24 h尿蛋白（urine protein，UP）、血尿β2微球蛋白（Blood/urineβ2 microglobulin，B/Uβ2-m）、血清肌酐（Serum creatine，Scr）及尿微量白蛋白/肌酐比值（urinary micro albumin-to-creatine ratio，UACR）。结果：（1）两组治疗前后血压下降比较，差异有统计学意义（P<0.01）。（2）两组患者的24 h UP、B/Uβ2-m、Scr及UACR水平治疗前后比较均明显降低，且观察组治疗后水平较对照组下降更明显，比较差异有统计学意义（P<0.05）。结论：贝尼地平或氨氯地平联合氯沙坦治疗原发性高血压合并微量蛋白尿患者，其降压效果相当，但在降低24 h UP、B/Uβ2-m、Scr及UACR方面贝尼地平优于氨氯地平，有更好的肾保护作用。%Objective:To investigate the therapeutic effect and renal effect protection of benidipine combined with iosartan for patients with hypertension with microalbuminuria.Method:We selected 116 patients diagnosed hypertension with microalbuminuria in our hospital,and randomly divided them into two groups. 58 patients of the control group were taken Amlodipine and Losartan,and 58 patients of the observation group were taken Losartan and Bnidipine. Before and after treatment,blood pressure was measured and 24 h UP,B/Uβ2-m,Scr,UACR were detected.Result:(1) Compared the two groups before and after treatment,the blood pressure lowering was significant different(P<0.01).(2) After treatment,the level of 24 h UP, B/Uβ2-m,Scr,UACR between the two groups significantly decreased (P<0.01),and the observation group were significantly lower than the control group(P<0.05).Conclusion:The antihypertensive efficacy which Benidipine or Amlodipine combined with Losartan in the treatment of patients with hypertension with microabuminuria are equivalent,but Benidipine is better than Amlodipine in reducing 24 h UP,B/Uβ2-m,Scr and UACR.So Benidipine has the better renal protective effect.