摘要
目的：探讨小剂量苯磺酸氨氯地平与缬沙坦联用治疗单纯舒张期高血压（IDH）的降压作用及对内生肌酐清除率（Ccr）的影响。方法：将本科62例初发单纯舒张期高血压患者随机分为2组，对照组30例仅予苯磺酸氨氯地平，治疗组32例联用缬沙坦，观察8周，比较2组治疗前后血压、内生肌酐清除率、心率、生化指标变化情况。结果：两组患者治疗前各指标基线特征无明显差异，治疗组降压作用总有效率达93％，对照组65％，治疗组舒张压治疗前（103．5±7．5）mmHg（1mmHg=0．133kPa）降至治疗后（82．6±5．8）mmHg；对照组治疗前（103．8±8．4）mmHg降至治疗后（88．1±5．4）mmHg，两组比较有统计学意义（P〈0．05），治疗组血清肌酐清除率由（65．2±15．1）升至（70．0±18．2）mL／（min·1．73m^2），升高6．8％，差异有统计学意义（P〈0．05）；对照组则无明显变化[（65．8±14．6）比（66．3±15．2）mL／（min·1．73m^2）P=0．637]；治疗组提高Ccr的作用明显优于对照组，有统计学意义（P〈0．001）；两组患者出现不良反应轻微。结论：苯磺酸氨氯地平与缬沙坦联用治疗单纯舒张期高血压降压疗效好，不良反应小，并可提高血清肌酐清除率，改善肾功能。
Objective ：To investigate the effect of small-dose amlodipine besylate plus valsartan on blood pressure and calculated creatinine clearance in patients with isolated diastolic hypertension. Methods： Sixty-two patients with primary isolated diastolic hypertension were randomized into two groups to be treated with amlodipine besylate alone （ control group, n = 30 ） or amlodipine besylate plus valsartan （ treatment group, n = 32 ） for 8 weeks. Clinical blood pressure （ CBP）, calculated creatinine clearance （Ccr）, heart rate and biochemistry of these patients were examined before and after the treatment. Results： At baseline, clinical characteristics of the participants in the 2 groups were similar. The total rate of antihypertensive response in two groups was 93% in the treatment group vs 65% in the control group. The CBP was shown to reduce from 103.5 ± 7.5 mmHg at baseline to 82.6 ± 5.8 mmHg after 8 weeks in the treatment group, compared with 103.8± 8.4 mmHg to 88.1 ± 5.4 mmHg in the control group （ 1 mmHg = 0. 133 kPa） , with a significant difference between two groups （P 〈0. 05）. There was a significant 6.8% rise in calculated creatinine clearance in the treatment group from baseline [ （65.2± 15.1 ） to （70.0 ± 18.2 ） mL/ （ min · 1.73 m^2 ）, （P〈0. 05）], but not in the control group [（65.8±14.6） to （66.3±15.2） mL/ （min · 1.73m^2）, P=0.637]. Patients in the treatment group received more benefits in terms of Cer elevated （P 〈 0.001 ）. Adverse effects appeared mild and comparable in the both groups. Conclusion： The combination therapy with small-dose amlodipine besylate plus valsartan may lower blood pressure effectively and safely in IDH patients, and increase the calculated ereatinine clearance to improve renal function.
出处
《广州医学院学报》
2010年第1期27-30,共4页
Academic Journal of Guangzhou Medical College
关键词
氨氯地平
缬沙坦
单纯舒张期高血压
血清肌酐清除率
amlodipine besylate
valsartan
isolated diastolic hypertension
endogenous creatinine clearance
