摘要
目的:比较服用不同降压药对高血压患者肾功能的影响。为高血压患者合理用药,减少肾功能损害提供参考。方法:研究对象选自宜兴市两个乡镇社区高血压流行病学调查人群,三次测量血压结果显示收缩压≥140 mm Hg和/或舒张压≥90 mm Hg,或自我报告高血压史并服药的对象确定为高血压病例。收集调查对象年龄性别等基本人口信息、服用降压药种类及临床生化指标资料。使用适合中国人的MDRD简化方程估算肾小球滤过率(estimate glomerular filtration rate,e GFR),并把e GFR作为评估肾功能的主要指标。同时把肌酐(creatinine,Cr)、尿素氮(usea nitrogen,Ur)和尿酸(uric acid,UA)作为评估肾功能参考指标。结果:排除服用降糖药对象,服用降压药者e GFR为(86±20)m L·min-1·1.73 m-2,显著低于不服用降压药者(92±17)m L·min-1·1.73 m-2(t=7.660,P<0.001);使用不同降压药物两两比较结果表明,服用珍菊降压片和降压片者e GFR分别为(85±23)m L·min-1·1.73 m-2、(84±14)m L·min-1·1.73 m-2,显著低于服用复方利血平者(88±21)m L·min-1·1.73 m-2,而服用复方利血平者e GFR低于不服用降压药者(92±17)m L·min-1·1.73 m-2,差异均有统计学意义(P<0.05)。校正性别、年龄、GLU、TG、HDL、BMI等协变量后,上述差异仍有统计学意义(P<0.05)。结论:珍菊降压片、降压片和复方利血平均对肾功能可能存在损害作用,长期服用这三类降压药的高血压患者应密切关注肾功能,减少肾损伤。
AIM： To explore the different effects of the antihypertensive drugs on renal function in hypertension patients,and raise cure rate of hypertension patients by reasonable cure. METHODS： A cross-sectional study of 4022 subjects were recruited by the epidemiological cluster sampling approach. Subjects with systolic blood pressure（ SBP）≥ 140 mm Hg,and /or diastolic blood pressure（ DBP） ≥90 mm Hg,or self-reported anti-hypertensive medication history were diagnosed as hypertension cases. The clinical characteristics of total cholesterol, triglyceride, high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,glucose and insulin were determined. A suitable for the Chinese simplified MDRD equation estimating e GFR,Cr,Ur and UA were taken as the reference index of renal function. RESULTS： Taking the antihypertensive pressure medicine e GFR（ 86 ± 20）m L·min-1·1. 73 m-2was lower than those not taking antihypertensive drugs e GFR（ 92 ± 17）m L·min-1·1. 73 m-2（ t = 7. 660,P〈 0. 001）.The different of renal function in the hypertension patients taken the antihypertensive drugs or not was statistically significant（ P〈0. 001）. The renal function damage of the hypertension patients taken Zhen Ju Jiang Ya Tablet and Jiang Ya Tablet was more serious than those taken reserpine（ P〈0. 05）. Further comparison between two,e GFR of hypertention patients taking Zhen Ju Jiang Ya Tablet（ 85 ± 23）m L·min-1·1. 73 m-2and patients taking Jiang Ya Tablet（ 84 ± 14） m L·min-1·1. 73 m-2were lower than patients taking reserpine（ 88 ± 21）m L·min-1·1. 73 m-2. Besides,e GFR of hypertention patients taking reserpine was lower than patients not taking any antihypertensive drugs. After adjustment for age,gender,GLU,TG,HDL and BMI,the diffence of renal function between different antihypertensive drugs were still statistically significant. CONCLUSION： Zhen Ju Jiang Ya Tablet,Jiang Ya Tablet and Reserpine resulted in significantly effect on renal impairment. Hypertension patients taking Zhen Ju Jiang Ya Tablet,Jiang Ya Tablet and reserpine for long time should pay attention to renal function.tients taking Zhen Ju Jiang Ya Tablet（ 85 ± 23）mL ·min-1·1. 73 m-2and patients taking Jiang Ya Tablet（ 84 ± 14） mL ·min-1·1. 73 m-2were lower than patients taking reserpine（ 88 ± 21）mL ·min-1·1. 73 m-2. Besides,e GFR of hypertention patients taking reserpine was lower than patients not taking any antihypertensive drugs. After adjustment for age,gender,GLU,TG,HDL and BMI,the diffence of renal function between different antihypertensive drugs were still statistically significant. CONCLUSION： Zhen Ju Jiang Ya Tablet,Jiang Ya Tablet and Reserpine resulted in significantly effect on renal impairment. Hypertension patients taking Zhen Ju Jiang Ya Tablet,Jiang Ya Tablet and reserpine for long time should pay attention to renal function.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2015年第10期1144-1149,共6页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
江苏省卫生厅课题(H200839)
关键词
降压药
肾功能
肾小球滤过率
MDRD方程
antihypertensive drug
renal function
glomerular filtration rate
MDRD equation
