厄贝沙坦与贝那普利治疗高血压非糖尿病肾病临床观察.docVIP

厄贝沙坦与贝那普利治疗高血压非糖尿病 肾病临床观察（摘要） 重庆市大足县人民医院 李洪林 何文生 摘要：目的：观察厄贝沙坦与贝那普利治疗非糖尿病慢性肾病的高血压降压疗效。方法:79例患者肾内生肌酐清除率60ml/L，随机分为厄贝沙坦组，贝那普利组，观察12个月，每1~3月随访一次，同时观察内生肌酐清除率、血钾、尿蛋白量、血尿酸水平。结果：治疗12个月，两组患者平均血压有明显降低，厄贝沙坦从161.19±12.04mmHg降到129.12±7.65mmHg，舒张压从93.67±6.87mmHgj降到78.16±3.36mmHg；贝那普利组158.87±11.06mmHg降到129.9±6.21mmHg，舒张压从91.60±4.52mmHgj降到77.55±3.12mmHg；内生肌酐清除率厄贝沙坦组和贝那普利组分别降0.60ml/L和0.71ml/L（p＞0.05）。血钾水平厄贝沙坦组增加4.2%，贝那普利组增加10.2%，尿酸贝那普利组增加4.4%，厄贝沙坦组减少17%，（P0.001），两组间平均尿蛋白厄贝沙坦1.95±0.44g/天降到1.26±0.46g/天，贝那普利从1.76±0.33g/天降到1.40±0.45g/天，（P=0.042）。结论：厄贝沙坦与贝那普利降压效果相当，还能较大程度降低非糖尿病肾病患者的蛋白尿，不增加血钾水平，同时显著降低血尿酸水平。 关键词：血管紧张素转换酶抑制剂； 血管紧张素Ⅱ受体阻滞剂 ；高血压 ；厄贝沙坦；贝那普利 慢性肾病 Irbesartan in hypertensive non-diabetic chronic kidney disease. Comparative study with Benazepril Li Honglin He Wen-sheng (De partment of Cardiology,the People,s Hosptial of Dazu County, Dazu402360，China) Abstact:Objective To obserbe the curative effect of Irbesartan and Benazepril on hypertensive non-diabetic chronic kidney disease on basis of general treatment.Methods 79patients with hypertensive non-diabetic chronic kidney disease (CCr 60 ml/min): were randomly divided into Irbesartan group and Benazepril group .The treatment lasted for 12 month.The renal function（ CCr）, serum potassium, proteinuria and serum uric acid were determined once 3 months.Results: At 12 months, Mean systolic BP was decreased from 161.19?2.04/91.60?.52 mmHgc to 129.12?.65 /77.55?.12mmHgHg in Irbesartan group, and from 158.87?1.06t/91.60?.52mmHgn to 91.60?.52m/77.55?.12mmHgn in Benazepril group. CrCl reduction with Irbesartan Was 0.60ml/L和0.71ml/L with Benazepril. The antiproteinuric effect was higher with Irbesartan (from1.95±0.44g to 1.26±0.46g /day). Benazepril (from 1.76±0.33g to 1.40±0.45g /day), being statistically significant the reduction percentage between the two groups (p = 0.041). Serum K+ level do not change in Irbesartan group and increased 10% in Benazepril group (p 0.001). Uric acid was decreased by Irbesartan in 17% and increased in 4.4%