苯磺酸左氨氯地平在老年高血压伴微量蛋白尿患者中的应用观察  

Application of levamlodipine besylate in elderly patients with hypertension and microalbuminuria

作　　者：巩江华 何新霞 李凝香 李枫 李坚 童莉 邢宏利 GONG Jiang-hua;HE Xin-xia;LI Ning-xiang;LI Feng;LI Jian;TONG Li;XING Hong-li(Department of General Medicine,Hengshui People’s Hospital,Hengshui 053000,Hebei Province,China;Medical Insurance Office,Hengshui People’s Hospital,Hengshui 053000,Hebei Province,China;Department of Hepatobiliary Surgery,Hengshui People’s Hospital,Hengshui 053000,Hebei Province,China)

机构地区：[1]衡水市人民医院全科医学科,河北衡水053000 [2]衡水市人民医院医保办公室,河北衡水053000 [3]衡水市人民医院肝胆外科,河北衡水053000

出　　处：《中国临床药理学杂志》2023年第16期2297-2301,共5页The Chinese Journal of Clinical Pharmacology

基　　金：河北省医学科学研究重点课题计划基金资助项目(20181579)。

摘　　要：目的观察苯磺酸左氨氯地平在老年高血压伴微量蛋白尿患者中的应用效果。方法将老年原发性高血压伴微量蛋白尿(尿微量蛋白/肌酸酐<30 mg·g^(-1))患者随机分为对照组和试验组。对照组予以厄贝沙坦片,初始用量每次150 mg,每日1次,结合血压控制情况调整剂量,不超过300 mg·d^(-1),口服;试验组在对照组的基础上联合苯磺酸左氨氯地平片,每次2.5 mg,每日1次,口服;2组均连续治疗6个月,期间每3个月门诊随访1次,不适随诊。比较2组动态血压指标[24 h平均收缩压(24 h SBP)、24 h收缩压负荷(24 h SBPL)、24 h平均舒张压(24 h DBP)、24 h舒张压负荷(24 h DBPL)]、肾功能指标[尿白蛋白排泄率(UAER)、血肌酸酐(SCr)、尿素氮(BUN)、尿蛋白与肌酸酐比值(UACR)]、微炎症指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、动脉弹性指标[心-踝血管指数(CAVI)、大动脉弹性指数(C1)]、临床疗效及药物不良反应发生情况。结果试验组和对照组各40例。试验过程中,无脱落病例。试验组和对照组总有效率分别为100.00%(40例/40例)和85.00%(34例/40例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组24 h SBP分别为(130.72±9.81)和(137.45±9.16)mmHg,24 h DBP分别为(80.57±5.45)和(85.22±5.65)mmHg,UAER分别为(110.26±14.56)mg/24 h和(132.68±16.42)mg/24 h,UACR分别为(20.24±7.36)和(26.76±8.42)mg·g^(-1),CRP分别为(4.25±1.07)和(5.94±1.35)mg·L^(-1),IL-6分别为(10.28±3.14)和(15.58±3.76)pg·mL^(-1),TNF-α分别为(22.16±5.24)和(28.91±6.18)pg·mL^(-1),差异均有统计学意义(均P<0.05)。试验组和对照组药物不良反应发生率分别为10.00%(4例/40例)和5.00%(2例/40例),差异无统计学意义(P>0.05)。结论在厄贝沙坦治疗基础上,老年高血压伴微量蛋白尿患者用苯磺酸左氨氯地平治疗能更好控制血压、延缓肾功能损害、减轻微炎症状态、改善血管弹性,且不增加药物不良反应发�Objective To observe the application effects of levamlodipine besylate on elderly patients with hypertension complicated with microalbuminuria.Methods Eighty elderly patients with essential hypertension complicated with microalbuminuria(urine microalbumin/creatinine<30 mg·g^(-1))were divided into control group and treatment group.The control group was given oral administration of irbesartan tablets(initial dosage of 150 mg·d^(-1) and once a day,and the dosage was adjusted according to the control of blood pressure but was no more than 300 mg·d^(-1)).The treatment group was additionally treated with levamlodipine besylate tablets(2.5 mg a time,once a day)on the basis of control group.Both groups were treated continuously for 6 months,and the outpatient follow-up was conducted every 3 months and diagnosis and treatment were performed at any time when any discomfort occurred.The ambulatory blood pressure indicators[24 h mean systolic blood pressure(24 h SBP),24 h systolic blood pressure load(24 h SBPL),24 h mean diastolic blood pressure(24 h DBP),24 h diastolic blood pressure load(24 h DBPL)],renal function indicators[urinary albumin excretion rate(UAER),serum creatinine(SCr),blood urea nitrogen(BUN),urinary albumin to creatinine ratio(UACR)],microinflammatory indicators[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],artery elasticity indicators[cardio-ankle vascular index(CAVI),large artery elasticity index(C1)],clinical efficacy and adverse reactions were compared between the two groups.Results There were 40 cases in treatment group and 40 cases in control group.There were no shedding cases during the treatment.The total effective rates in treatment group and control group were 100.00%(40 cases/40 cases)and 85.00%(34 cases/40 cases),the difference was statistically significant(P<0.05).After treatment,the 24 h SBP values in treatment group and control group were(130.72±9.81)and(137.45±9.16)mmHg,the 24 h DBP values were(80.57±5.45)and(85.22±5.65)mmHg,the UAER values in were(110.

关 键 词：高血压 微量蛋白尿 苯磺酸左氨氯地平 肾功能 心-踝血管指数 

分 类 号：R972[医药卫生—药品]