贝尼地平.pptVIP

治疗期间二组血压比较 二组血压下降变化无显著差异 蛋白尿与夜间SBP和脉压(Pulse Pressure)关系 蛋白尿与夜间SBP和脉压(Pulse Pressure)呈正相关 治疗前后二组ＵＡＣ变化比较 治疗前后，贝尼地平组UAC显著下降 研究结论 与ＡＲＢ药物联合治疗，贝尼地平比较氨氯地平 ： 二组降压疗效无显著差异； 贝尼地平组改善UAC显著优于氨氯地平组； 尿蛋白发生与夜间ＳＢＰ和脉压呈正相关； 贝尼地平与ARB联合治疗，能显著降低血压，同时改善肾功能 贝尼地平适用患者 高血压患者，合并微量蛋白尿 高血压患者其它CCB治疗不良反应明显 与ARB/ACEI联合治疗 谢谢 ！ Risk of Ischemic Heart Disease Related to SBP and Microalbuminuria The purpose of this study was to analyze prospectively whether the urinary albumin-to-creatinine (A/C) ratio could independently predict ischemic heart disease (IHD) in a population-based cohort. In 1983, urinary albumin and creatinine levels were measured, along with the conventional atherosclerotic risk factors, in 2,085 consecutive participants without IHD, renal disease, urinary tract infection, or diabetes mellitus. The participants were followed up until death, emigration, or December 31, 1993. IHD was identified by hospital diagnosis or listed as a cause of death. Seventy-nine individuals developed IHD. Microalbuminuria (MA) was defined as an A/C ratio 90 percentile (0.65 mg/mmol). When adjusted for other risk factors, the relative risk of IHD associated with MA was 2.3 (95% CI, 1.3 to 3.9, p=0.002), and the 10-year disease-free survival decreased from 97% to 91% (p0.0001) when MA was present. An interaction between MA and smoking was observed, and the presence of MA more than doubled the predictive effect of the conventional atherosclerotic risk factors for development of IHD. It is concluded that MA is not only an independent predictor of IHD but also substantially increases the risk associated with other established risk factors. ? Reference: Borch-Johnsen K, Feldt-Rasmussen B, Strandgaard S, Schroll M, Jensen JS. Urinary albumin excretion. An independent predictor of ischemic heart disease. Arterioscler Thromb Vasc Biol. 1999;19(8):1992-1997 * * 要纠正肾小球内压，重要的是要减轻前负荷（降低全身血压）或减轻后负荷（扩张出球小动脉） ［参　考］ ?肾小球内压升高是肾功能障碍（肾硬化）的原因之一。 ?要纠正肾小球内压，重要的是要减轻前负荷（降低全身血压）或减轻后负荷（扩张出球小动脉） ?ACE抑制剂(ACEI)和血管紧张素II受体拮抗剂(ARB)主要扩张