【摘要】 目的观察氨氯地平联合替米沙坦治疗老年高血压合并早期肾损害的临床疗效。方法老年高血压合并尿微量白蛋白(MAU)阳性者104例,随机分为氨氯地平联合替米沙坦组(观察组)52例,氨氯地平组(对照组)52例。观察组给予口服氨氯地平联合替米沙坦片,对照组单纯给予氨氯地平。观察治疗后8周血压下降和MAU、血β2微球蛋白(β2-MG)、尿β2-MG、尿N-乙酰-B-D氨基葡萄糖苷酶(NAGE)、血管紧张素Ⅱ(AngⅡ)及肝、肾功能变化情况。结果两组治疗2周、4周、6周和8周,收缩压和舒张压均有下降的趋势(P<0.01)。观察组MAU、血β2-MG、尿β2-MG、尿NAGE、血AngⅡ的减少较对照组更明显,分别为(67.2±35.2)mg/d vs(140.5±28.3)mg/d,(3.0±1.9)mg/d vs(3.3±1.3)mg/d,(151.4±1.2)mg/d vs(190.2±1.0)mg/d,(20.4±5.5)U/L vs(21.6±3.6)U/L,(54.1±24.1)ng/L vs(55.7±6.9)ng/L(P<0.05)。肝功能(丙氨酸转氨酶,天冬氨酸转氨酶)、肾功能(肌酐)变化两组间差异无统计学意义。结论氨氯地平联合替米沙坦治疗老年高血压合并早期肾损害临床疗效优于单纯使用氨氯地平。更多还原

【Abstract】 Objective To observe the therapeutic effect of amlodipine jointed with telmisartan on old hypertensive patients with early kidney damage.Methods Olderly patients with hypertension and urinary albumin(MAU) positive 104 cases,were randomly divided into two groups,amlodipine jointed with telmisartan(observer group,52 cases) and amlodipine(control group,52 cases).The patients in observer group were given oral amlodipine sustained-release tablets jointing with telmisartan,while the patients in control group were simply given amlodipine sustained-release tablets.Blood pressure,MAU,blood and urinary β2 microglobulin(β2-MG),urinary microalbumin(UMAE),urinary NAG enzyme(NAGE),blood angioension Ⅱ(AngⅡ),liver and kidney function were measured after eight weeks of treatment.Results Treatment of 2 weeks,4 weeks,6 weeks and 8 weeks,systolic blood pressure and diastolic blood pressure in both groups had a downward trend(P<0.01).The two drugs combined decreased in MAU,β2-MG,UMAE,NAGE,AngⅡ in observer group even more obviously than those of control group,respectively,(67.2±35.2) mg/d vs(140.5±28.3) mg/d,(3.0±1.9) mg/d vs(3.3±1.3) mg/d,(151.4±1.2) mg/d vs(190.2±1.0) mg/d,(20.4±5.5) U/L vs(21.6±3.6) U/L,(54.1±24.1) ng/L vs(55.7±6.9) ng/L(all P<0.05).Kidney(creatine,Cr) and liver(alanine aminotrans-ferase,ALT;aspartate aminatrans-ferase,AST) function had no obvious changes.Conclusion Therapeutic effect of amlodipine jointed with telmisartan on old hypertensive patients with early kidney damage is better than that of simply use of amlodipine in old people.更多还原