替米沙坦联合氨氯地平治疗慢性肾脏病早期高血压临床效果观察

摘要

目的：探讨替米沙坦联合氨氯地平治疗慢性肾脏病（ CKD）早期高血压的临床效果。方法选取2012年3月至2014年2月在双流县第一人民医院就诊的80例 CKD早期高血压患者，按照随机数字表法随机分成观察组与对照组，每组40例。观察组给予替米沙坦联合氨氯地平口服，替米沙坦片80 mg／次，每日1次，氨氯地平片5 mg／次，每日1次，对照组给予氨氯地平口服，5 mg／次，每日1次，疗程均为8周，观察两组患者临床疗效、血压、肝肾功能及药物不良反应。结果观察组总有效率为95．0％（38／40），对照组总有效率为77．5％（31／40），两组疗效比较差异有统计学意义（P＜0．05）；观察组和对照组治疗后收缩压和舒张压均显著下降[（118±15） mmHg（1 mmHg ＝0．133 kPa）比（155±20） mmHg，（138±12） mmHg 比（153±22） mmHg；（83±12） mmHg 比（102±15） mmHg，（92±12） mmHg比（102±20） mmHg，P＜0．01]，观察组显著低于对照组（P＜0．05）；观察组和对照组微量白蛋白（mALB）、肌酐治疗后均较本组治疗前显著下降[mALB：（63±23）mg／d比（152±26）mg／d，（93±26） mg／d 比（151±27） mg／d，P ＜0．01；肌酐：（115±7） mmol／L 比（121± 10） mmol／L，（116±7） mmol／L比（121±8） mmol／L，P＜0．01]，观察组治疗后mALB 显著低于对照组治疗后（ P＜0．01）；两组药物不良反应均较轻微。结论替米沙坦联合氨氯地平治疗CKD早期高血压安全、有效。%Objective To study the clinical effect of the telmisartan and amlodipine therapy for early hypertension of chronic kidney disease(CKD).Methods From Mar.2012 to Feb.2014,80 CKD patients with early hypertension in Shuangliu County First People′s Hospital were included in the study and divided into two groups according to random number table method,40 cases in each group.The observation group was given telmisartan joint amlodipine orally,telmisartan tablets 80 mg/time,1 time/day,amlodipine 5 mg/time, 1 time/day;the control group was given oral amlodipine,5 mg/time,1 time/day,a course was 8 weeks.The clinical efficacy,blood pressure,liver and kidney function and adverse drug reactions of the two groups were observed.Results Total effective rate of the observation group was 95.0%(38/40),of the control group was 77.5%( 31/40 ) , there was significant difference between the two groups ( P <0.05 ); blood pressure were decreased significantly after treatment in both groups[(118 ±15) mmHg vs (155 ±20) mmHg, (138 ±12) mmHg vs (153 ±22) mmHg;(83 ±12) mmHg vs (102 ±15) mmHg,(92 ±12) mmHg vs (102 ±20) mmHg,P<0.01],observation group decreased than the control group(P<0.05);micro albu-min (mALB),creatinine (Cr) of both groups were significantly decreased after treatment[mALB:(63 ± 23) mg/d vs (152 ±26) mg/d,(93 ±26) mg/d vs (151 ±27) mg/d,P<0.01;Cr:(115 ±7) mmol/L vs (121 ±10) mmol/L,(116 ±7) mmol/L vs (121 ±8) mmol/L,P <0.01],the mALB of the observation group after treatment was significantly lower than the control group(P<0.01);adverse drug reactions of both groups were mild.Conclusion Telmisartan combined with amlodipine is safe and effective for early hyper-tension of patients with CKD.