摘要
目的:观察以氨氯地平为基础的联合降压方案对高血压肾病患者的疗效及不良事件。方法:研究对象来源于中国高血压综合干预研究项目,福建地区纳入的252例原发性高血压患者中符合代谢综合征的共103例。采用多中心、随机对照、盲终点评估临床试验方法,观察A组(初始小剂量氨氯地平+复方阿米洛利,47例)和B组(小剂量氨氯地平+替米沙坦,56例)1年内的降压效果和不良事件。结果:(1)治疗1年时,血压达标率B组高于A组,分别为89.39%和78.24%,比较差异有统计学意义(P=0.002)。(2)两组血压较治疗前均有显著性下降,B组降压作用优于A组,1年时舒张压下降幅度分别为(13.1±7.4)mm Hg和(9.5±9.9)mm Hg,比较差异有统计学意义(P=0.047)。(3)两组不良事件比较差异无统计学意义(P>0.05),A组出现1例因低血压引起脑卒中事件。结论:低剂量氨氯地平联合替米沙坦能更安全有效地控制高血压肾病患者的血压。鼓励患者家中自测血压及定期监测24 h动态血压可有效防止低血压等不良事件。
Objective： To observe the therapeutic effect and adverse events of amlodipine-based antihypertensive combination regimen in the treatment of hypertensive nephropathy. Method：There were 103 hypertensive nephropathy from CHIEF （Chinese Hypertension Intervention Efficacy Study） which enrolled a total of 252 hypertensives. This project was a multi-centre, randomized, controlled and blind-endpoint trial. Patients would be randomly assigned to group A （low-dose amlodipine and diuretics, 47 cases）or group B （amlodipine and telmisartan, 56 cases）. Therapeutic effect and adverse events were observed for one year. Result：（1）The control rate of group B was higher than that of group A. There was significant difference of the control rate between group A（ 78.24%） and group B（89.39%）（P=0.002） . （2）Blood pressure of the two groups both significantly decreased after treatment. The antihypertensive effect of group B was better than that of group A, and the reducing range in diastolic blood pressure of the two groups had significant differences after 1 year of treatment （13.1±7.4） mm Hg VS. （9.5±9.9）mm Hg （P=0.047）. （3）The incidence rate of adverse events did not have difference between the two groups （P〉0.05）. One case of stroke event occurred in group A due to the hypopiesia.Conclusion：Low-dose amlodipine combined with telmisartan has better clinical efficacy and safety in the treatment of hypertensive nephropathy. Encourage patients to measure the blood pressure themselves at home and monitor the 24 h ambulatory blood pressure regularly can prevent the hypopiesia.
出处
《中国医学创新》
CAS
2013年第33期1-3,共3页
Medical Innovation of China
基金
国家"十一五"科技支撑计划项目(2006BAI01A03)
关键词
高血压肾病
疗效
不良事件
Hypertensive nephropathy
Therapeutic effect
Adverse event
