吲哒帕胺联合氯沙坦对老年高血压病人血尿酸及β2-微球蛋白的影响

目的 探讨氯沙坦联合吲哒帕胺对老年高血压患者的血压、血尿酸（UA）及血、尿β2-微球蛋白（β2-MG）的影响。方法 50例老年高血压患者随机分成两组，对照组（吲哒帕胺组）24例，观察组（氯沙坦加吲哒帕胺组）26例，观察12w，比较治疗前后患者血压、血钾、血UA及血、尿β2-MG等指标的变化。结果 治疗后两组收缩压及舒张压均较治疗前明显下降（P〈0．01），两组比较无差异（P〉0．05）；对照组治疗前后比较，血UA浓度明显升高（P〈0．01），血、尿β2-MG浓度无明显变化，血钾明显降低（P〈0．05），观察组治疗前后血UA及血、尿β2-MG均明显下降（P〈0．01）。结论 吲哒帕胺和氯沙坦联合治疗老年高血压病，较单独用药更有效地控制血压，降低血UA及减少低血钾的发生，保护靶器官，具有良好的安全性和耐受性。

Clinical observation of the blood pressure-independent effect of valsartan on reducing microalbuminuria for patients with type 2 diabetes mellitus

Objective To evaluate the therapeutic effect and safety of the blood pressure-independent role of valsartan on the patients with type 2 diabetic mellitus (T2DM) with microalbuminuria (MAU).Methods 137 patients with T2DM and MAU complicating with or without hypertension,were randomly assigned to valsartan group or amlodipine group,period of treatment as 12 weeks. A target blood pressure (BP) was 135/85 mmHg. Urinary albumin excretion rate (UAER) and BP in two groups were determined before and after treatment.Results The UAER at 12 week in valsartan group and amlodipine group reduced 56% and 92%,there was significant difference between two groups (P<0.001). Valsartan lowered similarly UAER in both the hypertensive and normotensive subgroups without significant changes before and after treatment (P>0.05). For the same level of attained BP reduction,valsartan lowered UAER more effectively than amlodipine.Conclusions Valsartan could play BP-independent reductive MAU role in patients with diabetic nephropathy.