中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
33期
1-2,3
,共3页
高血压肾病%疗效%不良事件
高血壓腎病%療效%不良事件
고혈압신병%료효%불량사건
Hypertensive nephropathy%Therapeutic effect%Adverse event
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。
目的：觀察以氨氯地平為基礎的聯閤降壓方案對高血壓腎病患者的療效及不良事件。方法：研究對象來源于中國高血壓綜閤榦預研究項目，福建地區納入的252例原髮性高血壓患者中符閤代謝綜閤徵的共103例。採用多中心、隨機對照、盲終點評估臨床試驗方法，觀察A組（初始小劑量氨氯地平+複方阿米洛利，47例）和B組（小劑量氨氯地平+替米沙坦，56例）1年內的降壓效果和不良事件。結果：（1）治療1年時，血壓達標率B組高于A組，分彆為89.39%和78.24%，比較差異有統計學意義（P=0.002）。（2）兩組血壓較治療前均有顯著性下降，B組降壓作用優于A組，1年時舒張壓下降幅度分彆為（13.1±7.4）mm Hg和（9.5±9.9）mm Hg，比較差異有統計學意義（P=0.047）。（3）兩組不良事件比較差異無統計學意義（P>0.05），A組齣現1例因低血壓引起腦卒中事件。結論：低劑量氨氯地平聯閤替米沙坦能更安全有效地控製高血壓腎病患者的血壓。鼓勵患者傢中自測血壓及定期鑑測24 h動態血壓可有效防止低血壓等不良事件。
목적：관찰이안록지평위기출적연합강압방안대고혈압신병환자적료효급불량사건。방법：연구대상래원우중국고혈압종합간예연구항목，복건지구납입적252례원발성고혈압환자중부합대사종합정적공103례。채용다중심、수궤대조、맹종점평고림상시험방법，관찰A조（초시소제량안록지평+복방아미락리，47례）화B조（소제량안록지평+체미사탄，56례）1년내적강압효과화불량사건。결과：（1）치료1년시，혈압체표솔B조고우A조，분별위89.39%화78.24%，비교차이유통계학의의（P=0.002）。（2）량조혈압교치료전균유현저성하강，B조강압작용우우A조，1년시서장압하강폭도분별위（13.1±7.4）mm Hg화（9.5±9.9）mm Hg，비교차이유통계학의의（P=0.047）。（3）량조불량사건비교차이무통계학의의（P>0.05），A조출현1례인저혈압인기뇌졸중사건。결론：저제량안록지평연합체미사탄능경안전유효지공제고혈압신병환자적혈압。고려환자가중자측혈압급정기감측24 h동태혈압가유효방지저혈압등불량사건。
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.
