氯沙坦和氨氯地平联合或单独用药对伴有早期肾功能损害的非杓型高血压患者的疗效观察.docVIP

精品论文 参考文献 氯沙坦和氨氯地平联合或单独用药对伴有早期肾功能损害的非杓型高血压患者的疗效观察 徐利1 石丹2(通讯作者) (1乐山市五通桥区人民医院内二科 四川乐山 614800；2都江堰市人民医院心内科 四川都江堰 611830） 【中图分类号】R972.4【文献标识码】A【文章编号】1672-5085（2012）29-0231-02 【摘要】目的 观察联合使用长效降压制剂对伴有早期肾功能损害的非杓型高血压的疗效。方法 90例２级和３级伴有早期肾功能损害的非杓型高血压患者随机分为3组：氯沙坦100mg组、氨氯地平10mg组和氯沙坦50mg合用氨氯地平5mg组，患者均于服药前及服药后6周，采用动态血压监测系统进行血压监测，同时测定各组尿素氮、肌酐、血清、尿beta;2-MG和尿微量白蛋白。结果 服药6周后，联合用药组24h平均收缩压下降值、24h平均舒张压下降值、夜间平均收缩压下降值和平均舒张压下降值均显著大于对照组（均P＜0.05）；治疗后，联合用药组有17例昼夜节律由非杓型改变为杓型，显著多于对照，氯沙坦100mg组和分别有（4例）和氨氯地平10mg组（6例）（P＜0.01）；联合用药组血清、尿beta;2-MG、尿微量白蛋白下降值均高于单一用药组（P＜0.01）。结论 长效降压制剂联合治疗２级和３级非杓型高血压，降压效果更好、降压平稳，更有利于血压的昼夜节律由非杓型恢复为正常的杓型，减轻高血压患者的早期肾功能损害。 【关键词】非杓型高血压 早期肾功能损害 联合用药 Comparison of the effects of losartan/amlodipine in combination versus alone in non-dipper hypertension patients with early kidney dysfunction Xu Li1，Shi Dan2 (1Internal medicine division of cardiovascular，Wutongqiao peoplersquo;s hospital of Leshan,Leshan 614800,China；2Internal medicine，peoplersquo;s hospital of Dujiangyan,Dujiangyan 611830,China ) 【Abstract】Objective To investigate effects of different methods of taking medicine in antihypertensive patients with non-dipper hypertension with early kidney dysfunction.Methods 90 patients with stage 2 or 3 non-dipper hypertensive with early kidney dysfunction　were　randomly divided into three groups to compare the efficacy of the combination of losartan/amlodipine 50/5 mg versus losartan 100 mg or amlodipine 10mg.All patients were checked blood pressure with ambulatory blood pressure monitoring and the level of BUN、Cr、serum/urinary beta;2-MG、MCA were measured before and 6 weeks after medication.Results The decrease in value of 24h SBP、24h DBP、dSBP and dDBP in group losartan/amlodipine 50/5 mg were significantly larger than control 6 weeks after medication(Plt;0.05).The circadian rhythm of blood pressure was changed from nondipper to dipper at 17case patients in group losartan/amlodipine 50/5 mg after treatment，which was 4and 6 in group losartan 100 mg and group amlodipine 10