缬沙坦-氢氯噻嗪合用治疗高血压早期肾损害的疗效

目的：评价缬沙坦．氢氯噻嗪合用治疗原发性高血压早期肾损害的有效性和安全性。方法：选择64例原发性高血压合并血、尿132微球蛋白增高的患者，采用单盲法随机分成2组：缬沙坦-氢氯噻嗪组32例，服用缬沙坦80mg、氢氯噻嗪12．5mg每日一次；缬沙坦组32例，服用缬沙坦80mg，每日一次，疗程为2个月。治疗前后分别检测患者静态血压和动态血压、血尿素氮、血肌酐、尿α1，微球蛋白、血和尿β2微球蛋白、尿微量白蛋白，比较治疗前后的变化。结果：单用缬沙坦或缬沙坦．氢氯噻嗪合用后，患者SBP、DBP均显著下降，缬沙坦-氢氯噻嗪组降压幅度比缬沙坦组显著（P〈0．01）；两组治疗后血和尿β2-微球蛋白、尿微量白蛋白含量均显著下降（P〈0．01），缬沙坦-氢氯噻嗪组较缬沙坦组下降更显著（P〈0．01）；两组血肌酐、血尿素氮、尿α1微球蛋白较治疗前也均有下降（P〈0．05）。结论：缬沙坦-氢氯噻嗪合用与缬沙坦单用均能有效降低血压、血和尿β2-微球蛋白、尿微量白蛋白含量，对高血压患者早期肾功能损害有一定保护作用，合用效果优于单用。

Effects of valsartan-hydrochlorothiazide combination on early renal damage of the patients with essential hypertension

AIM: To evaluate the efficacy and safety of valsartan-hydrochlorothiazide combination on renal early damage of the patients with essential hypertension. METHODS: Sixty-four patients with essential hypertension whose serum and urine levels of β_2-microglobulin were high were randomly single-blindly divided into two groups. 32 patients in valsartan-hydrochlorothiazide combination group took the compound preparation containing valsartan 80 mg and hydrochlo-rothiazide 12.5 mg once a day. 32 patients in valsartan group took valsartan 80 mg once a day. The treatment were lasted for two months. The static and dynamic blood pressure, blood urea nitrogen, serum creatinine, urine α_1-microglobulin, serum and urine β_2- microglobulin and urinary microalbumin were determined before and after the treatment. RESULTS: After the treatment , the levels of systolic and diastolic blood pressure were decreased significantly in two groups. The de- crease amplitude in valsartan-hydrochlorothiazide combination group was superior to that in valsartan group (P<0.01). Urine α_1-microglobulin, β_2-microglobulin in serum and urine were all decreased in two groups, and those in the valsartan-hydrochlorothiazide combination group were significantly lower than those in valsartan group( P < 0.01) . The blood urea nitrogen, serum creatinine and urine α_1 -microglobulin were all decreased in two groups( P < 0.05). CONCLUSION: Both of the two regimens have protective effects in early renal damage of the patients with essential hypertension and the combined treatment has better effect on reducing hypertension along with the concentration of urinary microalbumin and β_2-microglobulin in serum and urine.