氨氯地平和苯那普利联合治疗对高血压患者肾功能的影响

目的探讨氨氯地平、苯那普利单独治疗和联合治疗对高血压病患者肾功能的影响。方法66例高血压病患者随机分为3组:氨氯地平组(5mg,qd,22例);苯那普利组(10mg,qd,22例);氨氯地平和苯那普利联合治疗组(氨氯地平5mg,qd,苯那普利10mg,qd,22例)。疗程24周。治疗前、后观察肾功能指标变化。结果①氨氯地平、苯那普利及联合治疗组高血压病患者治疗后均能显著降低血压(P<0.01)及尿蛋白的排泄量。但联合治疗组降低尿蛋白排泄的幅度比氨氯地平组、苯那普利组明显高,而氨氯地平组和苯那普利组之间差异无统计学意义(P>0.05)。②治疗后,肾小球滤过率在联合治疗及苯那普利组明显增高,而氨氯地平组无明显变化。③三组治疗后尿白蛋白下降幅度与血压下降幅度均无显著相关。结论氨氯地平、苯那普利长期单独治疗均可减少蛋白尿,保护肾功能,两药联合治疗对减少蛋白尿、保护肾功能有一定相加作用。

Effect of amlodipine and benazepril combined therapy on renal function in patients with essential hypertension

Objective To examine the effect of amlodipine and benazepril on renal function in patients with essentialhypertension (EH). Methods Sixty six cases with EH were randomly divided into three groups: amlodipine group (5 mgqd, n=22), benazepril group (10 mg qd, n=22) and combined treatment group (amlodipine 5 mg qd+ benazepril 10mgqd, n=22). Treatment lasted for 24 weeks. Parameters of renal function were measured before and after treatment.Results After treatment, urinary total protein and albumin significantly decreased in all the three groups (P<0.01).The decrease extent in the combined treatment group was higher than that in the amlodipine and benazepril groups (P<0.01), while no significant difference was found between amlodipine and benazepril groups (P >0.05). Combinedtreatment and benazepril alone also significantly increased the glomerular filtration rate (P<0.05), but no significantchange was observed in the amlodipine group (P>0.05). No significant correlation between the decrease extent of urinaryalbumin and that of SBP or DBP was found among all the three groups (P>0.05). Conclusion The data suggested thatamlodipine combined with benazepril treatment should has additive effect on the decrease of urinary albumin excretionand protection of renal function.