辛伐他汀与贝那普利联用治疗原发性高血压的疗效观察——附53例分析

目的:观察辛伐他汀和贝那普利联合治疗轻、中度原发性高血压(高血压)患者的临床疗效和安全性.方法:103例患者随机分为2组:治疗组53例,辛伐他汀20 mg/d,贝那普利10 mg/d;对照组50例,贝那普利10 mg/d.用药10周后进行疗效分析.结果:治疗组总有效率为96%.对照组总有效率为84%,2组比效差异有统计学意义(p＜0.05).2组治疗前、后及组间的偶测血压比较,24小时、日间、夜间动态血压比较差异均有统计学意义(P＜0.05～0.01).治疗组12例、对照组9例治疗前血脂异常,治疗后治疗组调脂效果优于对照组(P＜0.05),治疗后治疗组的血压谷/峰比值优于对照组(P＜0.05).结论:辛伐他汀和贝那普利联合治疗高血压患者疗效较好,不良反应轻微,尤适用于高血压合并高血脂的患者.     

贝那普利联合氢氯噻嗪对合并多重危险因素高血压的疗效

目的观察贝那普利联合氢氯噻嗪对合并多重心血管危险因素高血压的疗效。方法87例原发性高血压患者分为A组(n=40,危险因素<3个)和B组(n=47,危险因素≥3个)。所有患者给予贝那普利10mg、氢氯噻嗪12.5mg,每日1次口服,共治疗24周。观察治疗前后静息坐位心率、血压和心脏超声参数的变化。结果治疗后两组患者的收缩压、舒张压及心脏超声参数等指标均明显下降(P<0.05~0.01),且A组心脏超声参数变化较B组明显(P<0.05)。结论贝那普利联合氢氯噻嗪能有效干预伴随多重心血管危险因素高血压患者的血压、脉压及左室肥厚。     

贝那普利对原发性高血压疗效的临床研究

目的研究贝那普利对原发性高血压患者的疗效.方法入选病例随机分为观察组60例（贝那普利）和对照组60例,观察组服用贝那普利片,对照组服用地尔硫[艹卓]片,检查血压,进行疗效评定.结果两组降压有效率比较,观察组总有效率93.3%,对照组总有效率76.7%.结论贝那普利治疗高血压病的疗效较好,值得临床推广使用.     

氨氯地平联合贝那普利治疗高血压合并糖尿病的疗效观察

目的:探讨氨氯地平联合贝那普利治疗高血压合并糖尿病的临床效果。方法:选取我院2016年12月～2018年12月收治的高血压合并糖尿病患者99例,随机分为参照组49例和研究组50例。参照组采用氨氯地平治疗,研究组采用氨氯地平联合贝那普利治疗。比较两组临床疗效。结果:研究组治疗总有效率显著高于参照组(P0.05);研究组治疗后SBP、DBP水平及24 h尿蛋白、mAlb、SCr水平均显著低于参照组(P0.05)。结论:氨氯地平联合贝那普利治疗高血压合并糖尿病的效果确切,可有效改善患者血压及肾功能,值得临床推广应用。     

硝苯地平联合贝那普利降压对高血压合并冠心病的治疗效果及其心肾保护作用

目的观察硝苯地平联合贝那普利降压对高血压合并冠心病的治疗效果及其心肾保护作用。方法选取2010年1月至2014年1月的133例高血压合并冠心病患者,按数字表法将其随机分为观察组与对照组。对照组67例单纯采用贝那普利进行治疗,观察组66例在对照组治疗方法的基础上联合使用硝苯地平治疗,观察两组患者治疗前后血压、肾功能以及疗效情况。结果与治疗前比较,两组收缩压与舒张压均显著下降,且治疗后观察组收缩压与舒张压低于对照组,差异均有统计学意义(P0.05);与治疗前比较,两组24 h尿蛋白量与血肌酐水平均显著下降,且治疗后观察组24 h尿蛋白量与血肌酐水平低于对照组,差异均有统计学意义(P0.05);观察组缺血事件的发生率为18.89%,显著低于对照组(43.24%),差异有统计学意义(P0.05)。结论采用硝苯地平与贝那普利联合治疗能够显著改善患者的症状,且对血压以及肾功能的改善要显著优于单独使用贝那普利,不良反应较少,值得推广。     

氨氯地平联合贝那普利治疗原发性高血压

目的 观察氨氯地平联合贝那普利治疗原发性高血压的临床疗效.方法 将102例原发性高血压随机分为两组,观察组53例,采用氨氯地平（5 mg）联合贝那普利（10 mg）治疗,对照组49例用氨氯地平（5 mg）单药治疗.治疗4周末若血压≥160/100 mm Hg剂量加倍.共治疗8周,以总有效率和舒张压下降差值作为主要疗效指标.结果 观察组总有效率为88.7%（47/53）、血压达标率为62.3%（33/53）;对照组总有效率为63.35%（31/49）、血压达标率为34.7%（17/49）.治疗前两组比较差异无统计学意义（P〉0.05）.治疗后两组间总有效率、血压达标率比较差异均有统计学意义（P〈0.001）.结论 氨氯地平联合贝那普利治疗原发性高血压患者的降压疗效明显优于氨氯地平单药治疗,值得临床推广应用.     

动态血压监测评价国产厄贝沙坦的降压疗效

目的 :评价国产厄贝沙坦的降压疗效及安全性。方法 :选取 1～ 2级原发性高血压患者 62例 ,随机单盲分为两组 ,厄贝沙坦组 3 2例 ,剂量 15 0～ 3 0 0mg ,1次 /d口服 ;贝那普利对照组 3 0例 ,剂量 10～ 2 0mg/d ,1次 /d口服。必要时均加氢氯噻嗪 12 5～2 5mg/d。观察治疗 4周及 8周末降压疗效、动态血压变化及不良反应。结果 :两组治疗 4周及 8周后显效率分别为 60 %、5 1%及62 %、5 4%;总有效率分别为 74%、70 %及 76%、72 %,组间无显著性差异。厄贝沙坦组治疗 8周后 2 4h血压监测收缩压及舒张压降压谷一峰比值分别为 74%及 70 %。结论 :国产厄贝沙坦治疗 1～ 2级原发性高血压效果持久、稳定 ,耐受性好 ,干咳副作用明显少于贝那普利     

贝那普利辅助治疗早期糖尿病肾病的临床疗效观察

目的:观察贝那普利辅助治疗早期糖尿病肾病(DN)的临床疗效.方法:将120例DN患者随机分为观察组和对照组各60例,对照组给予常规治疗,观察组在常规治疗基础上加用贝那普利治疗.结果:观察组疗效优于对照组(P＜0.01),且治疗后MA/Cr、Scr及24 h尿蛋白水平均较对照组改善明显(P＜0.01).结论:贝那普利辅助治疗早期DN效果理想,可明显改善临床症状及肾功能水平,值得临床推广.     

贝那普利联合吲达帕胺治疗高血压合并心力衰竭的疗效

目的探讨贝那普利联合吲达帕胺治疗高血压合并心力衰竭(简称心衰)患者的疗效。方法将60例高血压合并心衰患者按随机数字表法分为观察组和对照组,每组30例。2组患者均给予强心(洋地黄)、利尿(氯噻酮)以及血管紧张素受体拮抗剂(ARB)等治疗。观察组在上述治疗的基础上给予贝那普利(初始剂量)5mg,1次·d-1,必要时可根据患者耐受程度增加至10mg·d-1;吲达帕胺2.5mg,1次·d-1。2组均6个月为1个疗程。6个月后对2组患者的血压(SBP、DBP)、左室射血分数(LVEF)、6min步行距离的变化及疗效进行比较。结果 2组患者在治疗前SBP、DBP、LVEF和6min步行距离比较差异均无统计学意义(均P>0.05)。治疗6个月后2组患者SBP和DBP均较治疗前明显下降,观察组下降更为明显;LVEF和6min步行距离较治疗前明显增加,观察组增加更为显著(均P<0.05)。观察组总有效率为96.7%,对照组总有效率为73.3%,2组比较差异有统计学意义(P<0.05)。结论贝那普利联合吲达帕胺治疗高血压合并心衰可协同获得降压效果,改善患者心功能,疗效显著。     

贝那普利联合硝苯地平缓释片治疗高血压合并慢性肾病临床观察

目的探讨硝苯地平缓释片辅助用于高血压合并慢性肾病治疗疗效及相关药代动力学研究。方法选取82例高血压合并慢性肾病患者。随机分为对照组和观察组各41例。两组均行常规治疗,对照组给予贝那普利治疗,观察组给予贝那普利联合硝苯地平缓释片治疗,对比两组疗效及贝那普利药代动力学指标。结果两组治疗后血肌酐、24h尿蛋白定量及血压水平均显著低于治疗前,观察组改善效果显著优于对照组,差异有统计学意义(P0.05);两组C_(max)、AUC、t_(max)、t_(1/2)比较,无显著差异(P0.05);两组不良反应发生率比较,无显著差异(P0.05)。结论高血压合并慢性肾病患者给予硝苯地平缓释片辅助治疗,可有效保护肾脏,改善蛋白尿情况,调整血压水平,对贝那普利药代动力学无明显影响。     

Comparison of the efficacy and safety profiles of two fixed-dose combinations of antihypertensive agents, amlodipine/benazepril versus valsartan/hydrochlorothiazide, in patients with type 2 diabetes mellitus and hypertension: a 16-week, multicenter, randomized, double-blind, noninferiority study

BackgroundHypertension is a prevalent condition that is closely associated with chronic complications in patients with diabetes. Fixed-dose combination therapy is currently recommended for the treatment of hypertension due to the advantage of reducing the pill burden. However, the effects of combination therapy may be diverse because of the different components.ObjectivesWe examined blood pressure reduction and metabolic alterations after amlodipine/benazepril and valsartan/hydrochlorothiazide treatment in patients with type 2 diabetes mellitus and hypertension and microalbuminuria.MethodsThis randomized, double-blind, parallel comparison, noninferiority clinical trial included patients with type 2 diabetes mellitus and hypertension and microalbuminuria detected within the past year. After a 2-week, placebo run-in period, patients were assigned to treatment with amlodipine/benazepril or valsartan/hydrochlorothiazide for 16 weeks. The primary end point was mean change in diastolic blood pressure. The prespecified boundary for noninferiority was 3.5 mm Hg of the mean change in diastolic blood pressure between treatments (amlodipine/benazepril minus valsartan/hydrochlorothiazide). If the upper limit of the 95% CI fell within 3.5 mm Hg, amlodipine/benazepril would be considered noninferior to valsartan/hydrochlorothiazide.ResultsOf the 226 patients assessed for eligibility, 169 satisfied the inclusion/exclusion criteria and were assigned to a treatment group; 83 patients (54.2% male, mean age of 60.5 [10.0] years) in the amlodipine/benazepril group and 84 patients (64.3% male, mean age of 59.0 [10.6] years) in the valsartan/hydrochlorothiazide group received at least 1 dose of study medication and were included in the intention-to-treat population. In the per-protocol population, amlodipine/benazepril (n = 74) was noninferior to valsartan/hydrochlorothiazide (n = 78) with regard to the mean change in diastolic blood pressure (difference, ?0.9 mm Hg; 95% CI, ?3.5 to 1.6). The mean change in systolic blood pressure was not significantly different (2.4 mm Hg; 95% CI, ?1.2 to 6.0) between study groups (P = 0.195) in the per-protocol population. However, data from the intention-to-treat population suggest that patients in the amlodipine/benazepril group may have better metabolic outcomes than those in the valsartan/hydrochlorothiazide group; specifically, a preservation of the estimated glomerular filtration rate (5.7 mL/min/1.73 m² [95% CI, 1.9 to 9.6]; P = 0.004) and improvements in glycosylated hemoglobin (?0.5% [95% CI, ?0.7 to ?0.2]; P < 0.001), fasting triglycerides (?0.4 mmol/L [95% CI, ?0.7 to ?0.2]; P = 0.002), HDL-C (0.07 mmol/L [95% CI, 0.01 to 0.12]; P = 0.022), and uric acid (?57.5 μmol/L [95% CI, ?74.8 to ?40.3]; P < 0.001). There were no significant differences in adverse effects between groups, with the exception of more respiratory disorders in the amlodipine/benazepril group than in the valsartan/hydrochlorothiazide group (17 vs 5; P = 0 .006).ConclusionsThe study results suggest that amlodipine/benazepril is noninferior to valsartan/hydrochlorothiazide with regard to blood pressure reduction and that this combination exerts beneficial effects on renal function, glucose control, HDL-C, and triglyceride levels compared with valsartan/hydrochlorothiazide. However, respiratory adverse events (particularly coughing) were more frequently reported in the amlodipine/benazepril group. ClinicalTrials.gov identifier: NCT01375322.     

Efficacy and tolerability of a switch to fixed-dose combination therapy with amlodipine besylate/benazepril hydrochloride after monotherapy with amlodipine besylate: Data from the African-American subpopulation of a practice-based, open-label study (the LOGIC study)

Background: The LOGIC (LOtrel: Gauging Improved Control) study assessed the efficacy and tolerability of switching from amlodipine besylate monotherapy to fixed-dose combination therapy with amlodipine besylate/benazepril hydrochloride (HCI) in patients who were experiencing uncontrolled blood pressure (BP) or edema with monotherapy.Objective: This article reports the efficacy and tolerability of amlodipine besylate/benazepril HCI combination therapy in the predefined African-American population of the LOGIC study.Methods: This multicenter (1518 centers across the United States), practice-based, open-label, clinical trial enrolled patients with mild to moderate essential hypertension. Patients in group 1 had uncontrolled BP (sitting diastolic BP [DBP] ≥90 mm Hg and ≤110 mm Hg) during treatment with amlodipine besylate monotherapy 5 or 10 mg/d, and those in group 2 had controlled BP (sitting DBP ⩽90 mm Hg), but also had experienced edema during amlodipine besylate monotherapy. Participants were instructed to discontinue amlodipine besylate and were given amlodipine besylate/benazepril HCl 5/10 mg/d or 5/20 mg/d for 4 weeks. For group 1, the primary efficacy outcome was the change in mean sitting DBP (MSDBP) from baseline to week 4; a secondary efficacy outcome was the change in mean sitting systolic BP (MSSBP) from baseline to week 4. The primary efficacy outcome for group 2 was the percentage of patients whose edema improved with the switch to combination therapy. The secondary efficacy variables in group 2 were the changes in MSDBP and MSSBP from baseline to week 4. Patients in groups 1 and 2 were questioned about any adverse events that may have occurred since the previous visit. At both study visits, medications were reviewed, and the level of edema was assessed.Results: A total of 2055 African-American patients were enrolled in the study. At study end, African-American patients in group 1 (n = 1422 assessable patients) experienced significant reductions in MSSBP (13.9 mm Hg) and MSDBP (10.4 mm Hg) from those achieved during amlodipine besylate monotherapy (both P < 0.001). In group 2 (n = 266 assessable patients), 81% of African-American patients reported improvement in edema, and BP remained well controlled.Conclusions: In this study of an African-American subpopulation of patients with mild to moderate essential hypertension who had uncontrolled BP while receiving amlodipine besylate monotherapy, switching from amlodipine besylate monotherapy to fixed-dose amlodipine besylate/benazepril HCl combination therapy reduced BP to a greater extent than with amlodipine besylate alone, and reduced the incidence of edema in patients who were edematous but who had controlled BP. Fixed-dose combination therapy with amlodipine besylate/benazepril HCI has the potential to improve BP control, leading to improved clinical outcomes and enhanced treatment compliance.     

苯磺酸氨氯地平联合贝那普利对腹膜透析患者血压及血压变异性的影响

目的 观察苯磺酸氨氯地平联合贝那普利对腹膜透析患者血压及血压变异性的影响.方法 将165例高血压肾病或肾性高血压腹膜透析患者经过 2 周安慰剂导入期筛选出145例随机分为2组,治疗组80例:给予苯磺酸氨氯地平和贝那普利口服;对照组65例,对照组给予硝苯地平缓释片和贝那普利口服,治疗1月后随访血压24月,每1月随访1次,观察2组治疗前后血压、血压变异性的差异及心血管事件发生情况,包括心力衰竭(根据临床表现判断级NYHAⅡ 以上),急性冠脉综合征(不稳定性心绞痛、急性心肌梗死、心源性猝死).结果 2组治疗前后血压及血压变异性比治疗前明显下降(P ＜0.01),治疗组血压变异性降低幅度比对照组降低幅度大( P＜0.01),两组间血压降低幅度没有显著性差异(P ＞0.05),治疗后治疗组心血管事件发生率低于对照组( P＜0.01),心血管事件死亡率亦低于对照组(P ＜0.01).结论 治疗组和对照组都能有效的控制腹膜透析患者的血压,但治疗组能有效的降低腹膜透析患者的血压变异性,从而降低腹膜透析患者心血管事件发生率及心血管事件死亡率.     

氨氯地平联合贝那普利治疗老年原发性高血压效果观察

目的探讨氨氯地平联合贝那普利治疗老年原发性高血压的效果。方法选择我院住院或门诊明确诊断的老年原发性高血压60例,随机分为观察组与对照组各30例。对照组予氨氯地平治疗。观察组在此基础上加用贝那普利。两组均连续用药8周。观察两组临床疗效。结果两组治疗后舒张压和收缩压均明显下降,与治疗前比较差异均有统计学意义(P<0.01),治疗后两组间血压比较差异均有统计学意义(P<0.05);观察组总有效率为96.7%,对照组为83.3%,两组比较差异有统计学意义(P<0.05)。结论氨氯地平联合贝那普利治疗老年原发性高血压效果优于氨氯地平单独用药,且不良反应轻微。     

通心络胶囊并硝苯地平缓释片治疗高血压病临床观察

目的　观察通心络胶囊和硝苯地平缓释片的降压疗效。方法　 193例高血压病患者随机分为治疗组 (n =97)和对照组 (n =96 ) ,治疗组服用通心络胶囊和硝苯地平缓释片 ;对照组服用氨氯地平和贝那普利 ,记录每日血压变化和自觉症状、不良反应。结果　治疗 2周和 4周时治疗组的总有效率 (分别为 87 6 %、94 8% )均稍高于对照组 (分别为 81 2 %、92 7% ) ,但差异无显著意义 (P >0 0 5 )。结论　通心络胶囊并硝苯地平缓释片治疗高血压病疗效确切、安全、无不良反应。     

苯那普利治疗老年高血压疗效观察

目的 :观察苯那普利对老年高血压病的治疗效果 ,以及对心率、肾功能、血糖、血脂和电解质的影响。方法 :116例患者随机分为苯那普利治疗组 (治疗组 )和氨氯地平治疗组 (对照组 ) ,分别给予苯那普利和氨氯地平治疗 4周 ,测定治疗前后的血压、心率、肾功能、血糖、血脂和电解质 ,并进行比较。结果 :经自身前后对照 ,两药均有显著降压效果 (P <0 .0 1) ,对心率、血糖、血脂和电解质无明显影响 (P >0 .0 5 ) ,但治疗组肾功能显著改善 (P <0 .0 1)。结论 :苯那普利降压效果显著 ,对肾功能有保护作用 ,尤其适用于老年高血压病患者     

厄贝沙坦与苯磺酸氨氯地平治疗轻中度原发性高血压的疗效比较

目的:比较厄贝沙坦(安博维)与苯磺酸氨氯地平(络活喜)治疗轻中度原发性高血压的降压疗效.方法:将2008年1月至2009年12月于明确诊断为轻中度原发性高血压患者100例随机分为安博维组和络活喜组各50例,分别应用安博维和络活喜治疗,比较两组治疗8周时的降压疗效.结果:治疗2周、4周、6周和8周时安博维组和络活喜组的降压有效(率)分别为35例(70%)、38例(76%)、41例(82%)、43例(86%)和36例(72%)、39例(78%)、40例(80%)、42例(84%),两组各疗程均无显著性差异.结论:厄贝沙坦(安博维)与苯磺酸氨氯地平(络活喜)治疗轻中度原发性高血压均可获良好疗效,且无明显不良反应.     

Two multicenter, 8-week, randomized, double-blind, placebo-controlled, parallel-group studies evaluating the efficacy and tolerability of amlodipine and valsartan in combination and as monotherapy in adult patients with mild to moderate essential hypertension

BACKGROUND: Patients with hypertension may require combination therapy to attain the blood pressure targets recommended by US and European treatment guidelines. Combination therapy with a calcium channel blocker and an angiotensin II-receptor blocker would be expected to provide enhanced efficacy. OBJECTIVES: Two studies were conducted to compare the efficacy of various combinations of amlodipine and valsartan administered once daily with their individual components and placebo in patients with mild to moderate essential hypertension (mean sitting diastolic blood pressure [MSDBP] >/=95 and < 110 mm Hg). A secondary objective was to evaluate safety and tolerability. METHODS: The 2 studies were multinational, multicenter, 8-week, randomized, double-blind, placebo-controlled, parallel-group trials. In study 1, patients were randomized to receive amlodipine 2.5 or 5 mg once daily, valsartan 40 to 320 mg once daily, the combination of amlodipine 2.5 or 5 mg with valsartan 40 to 320 mg once daily, or placebo. In study 2, patients were randomized to receive amlodipine 10 mg once daily, valsartan 160 or 320 mg once daily, the combination of amlodipine 10 mg with valsartan 160 or 320 mg once daily, or placebo. The primary efficacy variable in both studies was change from baseline in MSDBP at the end of the study. Secondary variables included the change in mean sitting systolic blood pressure (MSSBP), response rate (the proportion of patients achieving an MSDBP <90 mm Hg or a >/= 10-mm Hg decrease from baseline), and control rate (the proportion of patients achieving an MSDBP <90 mm Hg). Safety was assessed in terms of adverse events (spontaneously reported or elicited by questioning), vital signs, and laboratory values. RESULTS: A total of 1911 patients were randomized to treatment in study 1 (1022 amlodipine + valsartan; 507 valsartan; 254 amlodipine; 128 placebo); 1250 were randomized to treatment in study 2 (419, 415, 207, and 209, respectively). In all treatment groups in both studies, the majority of patients were white (79.5% study 1, 79.4% study 2) and male (53.5% and 50.3%, respectively). The overall mean age was 54.4 years in study 1 and 56.9 years in study 2. The mean weight of patients in study 1 was higher than that in study 2 (88.8 vs 79.7 kg). The overall baseline mean sitting BP was 152.8/99.3 mm Hg in study 1 and 156.7/99.1 mm Hg in study 2. With the exception of a few combinations that included amlodipine 2.5 mg, the combination regimens in both studies were associated with significantly greater reductions in MSDBP and MSSBP compared with their individual components and placebo (P < 0.05). A positive dose response was observed for all combinations. The highest response rate in study 1 was associated with the highest dose of combination therapy (amlodipine 5 mg + valsartan 320 mg: 91.3%). Amlodipine 5 mg, valsartan 320 mg, and placebo were associated with response rates of 71.9%, 73.4%, and 40.9%, respectively. In study 2, the 2 doses of combination therapy were associated with similar response rates (amlodipine 10 mg + valsartan 160 mg: 88.5%; amlodipine 10 mg + valsartan 320 mg: 87.5%). Amlodipine 10 mg was associated with a response rate of 86.9%; valsartan 160 and 20 mg were associated with response rates of 74.9% and 72.0%, respectively; and placebo was associated with a response rate of 49.3%. Control rates followed a similar pattern. The incidence of peripheral edema with combination therapy was significantly lower compared with amlodipine monotherapy (5.4% vs 8.7%, respectively; P = 0.014), was significantly higher compared with valsartan monotherapy (2.1%; P < 0.001), and did not differ significantly from placebo (3.0%). CONCLUSIONS: In these adult patients with mild to moderate hypertension, the combination of amlodipine + valsartan was associated with significantly greater blood pressure reductions from baseline compared with amlodipine or valsartan monotherapy or placebo. The incidence of peripheral edema was significantly lower with combination therapy than with amlodipine monotherapy.     

贝那普利对原发性高血压患者血浆同型半胱氨酸水平和血管内皮功能的影响

目的研究贝那普利对原发性高血压患者血浆同型半胱氨酸（Hcy）水平和血管内皮功能的影响。方法原发性高血压患者77例，随机分为贝那普利组（40例）与常规治疗组（37例），另设健康对照组80例，贝那普利组与常规治疗组均限盐、低钠饮食、适当锻炼、减轻体重血压不迭标的常规治疗组口服利尿剂氢氯噻嗪治疗，贝那普利组给予贝那普利10mg，每日1次口服，治疗8周。比较治疗前后血浆Hcy、一氧化氮（NO）、血管性假性血友病因子（YWF）水平变化，超声测量肱动脉血流依赖性舒张功能（FMD）、肱动脉内径。结果原发性高血压患者血浆Hey水平明显高于健康对照组，贝那普利治疗后与治疗前比较，Hcy、vwF水平均降低，差异均有显著性（均P〈0．001）；NO、FMD明显升高（均P〈0．001），基础状态下肱动脉内径治疗后有减少趋势，但差异无显著性。常规治疗组治疗前后各指标比较，差异无显著性（P〉0．05）。结论原发性高血压患者Hcy水平明显高于健康对照组。贝那普利降压治疗同时可以降低Hcy水平，改善高血压患者的血管内皮功能。     

培哚普利和苯磺酸氨氯地平联合应用对高血压蛋白尿的作用

目的 观察培哚普利和苯磺酸氨氯地平联合应用治疗高血压蛋白尿的临床疗效.方法 将136例高血压合并肾脏损害蛋白尿的患者随机分为A、B两组,A组给予培哚普利4 mg/d和苯磺酸氨氯地平5 mg/d,B组给予苯磺酸氨氯地平5 mg/d和氢氯噻嗪12.5 mg/d,均治疗26周.两组治疗前及治疗后测血压、尿白蛋白、尿素氮(BUN)、血肌酐(Scr),并计算肌酐清除率(Ccr)和不良反应.结果 两组治疗后6.5个月,血压较前明显下降(P＜0.01),两组下降值比较差异无统计学意义(P＞0.05).两组治疗后尿蛋白均下降(P＜0.05),A组降低尿蛋白作用比B组更显著(P＜0.01).A组降低Scr、BUN更显著(P＜0.05).结论 培哚普利和氨氯地平联合应用能明显较平稳降低高血压,显著减少尿蛋白,有效保护肾功能.