氨氯地平、坎地沙坦联合应用对老年高血压并发2型糖尿病患者尿微量白蛋白的影响  

Effect of Two Kinds of Drugs Combination Therapy Amlodipine,Candesartan on Microalbuminuria in Elderly Patients with Type 2 Diabetes Mellitus and Hypertension

作　　者：李莉[1] 苏克文[1] 孙晓玫[1] 葛成林[1] 袁玲[2] 

机构地区：[1]安徽省淮南市第一人民医院老年内科,232007 [2]安徽省淮南市第一人民医院肾内科,232007

出　　处：《医学理论与实践》2010年第4期382-384,共3页The Journal of Medical Theory and Practice

摘　　要：目的:评价联合应用钙拮抗剂(左旋氨氯地平)和血管紧张素Ⅱ受体拮抗剂(ARB)(坎地沙坦)类药物及单用对老年高血压并发2型糖尿病患者血压及尿微量白蛋白(MAU)的影响。方法:高血压并发2型糖尿病伴尿微量白蛋白阳性门诊患者90例,随机分为联合用药组(左旋氨氯地平5 mg/d+坎地沙坦8 mg/d,n=30)、单用左旋氨氯地平组(5 mg/d,n=30)和单用坎地沙坦组(8 mg/d,n=30)。治疗2周后单用组剂量加倍以达到目标血压,疗程共3个月。记录治疗前后血压、MAU的变化及可能发生的不良事件。结果:治疗3个月后3组血压均较治疗前明显下降(P<0.01),但治疗后3组间血压比较差异无统计学意义;尿微量白蛋白3组均较治疗前减少(P<0.05);两个单用组与联合用药组MAU比较,P均<0.05,差异有统计学意义。结论:钙拮抗剂类药物和ARB类药物联用较单一药物剂量加倍对血压控制情况没有明显差异,但能明显改善老年高血压并发2型糖尿病患者的早期肾损害,提示有早期肾损害者应尽早联合降压治疗。Objective： To evaluate the effect of microalburninuria of combined treatment with calcium antagonist （levoamlodipine）（CCB）and the ARB （candesartan）, or levoamlodipine, candesartan monotherapy in elderly patients with type 2 diabetes mellitus and hypertension. Methods： Ninety cases of consecutive patients with type 2 diabetes mellitus and hypertension were randomized to receive levoamlodipine 5mg/d（n=30）, candesartan 8mg/d（n=30）, or a combination of levoamlodipine 5mg/d and candesartan 8mg/d （n= 30）for 3 months. After 2 weeks in monotherapy group dose was doubled to the third month＇end. The blood pressure as well as microaibuminuria were examed pre-and-post treatment and recorded the adverse events. Results： The treatment of three groups all significantly lowered BP（P〈 0. 01）, with no significantly statistical difference among them. The combination treatment group decreased urine MAU more significantly than either monotlaerapy approachea（P〈0. 05）. Conclusion： The combination of levoamlodipine and candesartan resulted in significantly more decrease in microalbuminuria than monotherapy with either agent in elderly patients with type 2 diabetes mellitus and hypertension.

关 键 词：左旋氨氯地平 坎地沙坦 高血压 尿微量白蛋白 2型糖尿病 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]