缬沙坦联合氨氯地平治疗肾性高血压患者的临床效果分析

倪丽

[摘要]目的 觀察缬沙坦联合氨氯地平治疗肾性高血压的临床效果。方法 从我院2014年1月～2017年6月接诊的慢性肾脏病合并肾性高血压患者中，选取86例患者纳入本研究，采用随机数字表法，将患者分为两组，每组43例。观察组患者采用缬沙坦联合氨氯地平治疗，对照组患者仅采用缬沙坦治疗。两组患者接受为期4个疗程的治疗。观察两组患者的血压、肾功能指标变化水平、用药安全性。结果 观察组患者的总有效率高于对照组，差异有统计学意义（P<0.05）。两组患者治疗后的收缩压（SBP）、舒张压（DBP）水平均低于本组治疗前，观察组治疗后的SBP、DBP水平均低于对照组（P<0.05）。两组患者治疗后的血肌肝（SCr）、血尿素氮（BUN）、24 h尿蛋白定量水平低于治疗前，观察组患者治疗后的肾小球滤过率（GFR）水平高于治疗前，差异有统计学意义（P<0.05）；观察组治疗后的SCr、BUN、24 h尿蛋白定量水平均低于对照组，GFR水平高于对照组（P<0.05）。两组的不良反应总发生率比较，差异无统计学意义（P>0.05）。结论 缬沙坦联合氨氯地平治疗慢性肾脏病合并肾性高血压的效果确切，在降血压和保护患者肾功能方面均具有显著效果，且药物安全性高，可在临床推广。

[关键词]缬沙坦；氨氯地平；慢性肾脏病；肾性高血压

[中图分类号] R544.1+4 [文献标识码] A [文章编号] 1674-4721（2018）5（b）-0021-04

Clinical effect analysis of Valsartan combined with Amlodipine in treatment of patients with renal hypertension

NI Li

Department of Nephrology，Central Hospital of Huizhou City in Guangdong Province，Huizhou 516001，China

[Abstract]Objective To observe the clinical effect of Valsartan combined with Amlodipine in the treatment of renal hypertension.Methods All of 86 patients with chronic kidney disease complicated with renal hypertension treated in our hospital from January 2014 to June 2017 were selected，the patients were divided into two groups by randomly number table method，and each group had 43 cases.The observation group was treated by Valsartan combined with Amlodipine，the control group was treated by only Valsartan.The two groups were treated 4 courses.The blood pressure，changes in renal function indicators，medication safety of the two groups were observed.Results the total effective rate of the observation group was higher than that of the control group，and there was a statistical significance （P<0.05）.After treatment，the level of SBP and DBP in both groups were lower than those in the control group and the level of SBP and DBP in the observation group were lower than those in the control group （P<0.05）.The level of SCr，BUN and 24 h urine protein in the two groups were lower than those before treatment and the glomerular filtration rate （GFR） level of the observation group was higher than that before treatment，and the differences were statistically significant （P<0.05）.The level of SCr，BUN and 24 h urine protein in the observation group were lower than those of the control group，and the level of GFR was higher than that of the control group （P<0.05）.There was no significant difference in the total incidence of adverse reactions between the two groups （P>0.05）.Conclusion The effect of Valsartan combined with Amlodipine in treatment of patients with renal hypertension is exact，it has significant effect in lowering blood pressure and protecting of renal function in patients，and the drugs were highly safety，It can be vigorously promoted in clinic.

[Key words]Valsartan；Amlodipine；Chronic kidney disease；Renal hypertension

慢性肾脏病（chronic kidney disease，CKD）所属肾内科，指各种原因引起的慢性肾脏结构和功能障碍，且肾脏损害病史在3个月以上。研究表明，糖尿病和高血压是导致CKD恶化的主要因素[1-2]。肾性高血压是因肾脏出现实质病变或因肾血管性病变发生血流动力学改变而导致血压升高的疾病，严格意义上来说，该疾病属继发性高血压。研究指出，约有50%的CKD患者合并肾性高血压，在合并症的影响下，会进一步加快肾功能减退的速度，并引起肢体水肿，提高心血管事件发生率[3]。不仅如此，高血压在加重肾损害的同时，还可能危及患者生命。因此，对于CKD合并肾性高血压的患者而言，及时降压，保护患者肾功能尤为重要。……