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Title:: bination of irbesartan and enalapril in improving early renal damage in hypertensive patients

作者:: 朱平先¹; 黎明¹; 曹金安²; 孙大勇²; 深圳市龙岗区：1.人民医院心内科, 广东深圳 518172;2.中心医院心内科，广东深圳 518116

Author(s):: ZHU Ping-xian¹; LI Ming¹; CAO Ji-nan²; SUN Da-yong²; 1.Department of Cardiology, Longgang People’s Hospital of Shenzhen City, 518172, China ; 2.Department of Cardiology, Longgang Central Hospital of Shenzhen City, Shenzhen 518116, China

关键词:: 原发性高血压; 伊贝沙坦; 依那普利; 肾功能损害

Keywords:: irbesartan; enalapril; essential hypertension; renal damagevv

分类号:: R972.4

DOI:: -

文献标识码:: A

摘要:: 目的: 评价伊贝沙坦合用依那普利对原发性高血压患者早期肾功能损害的有效性和安全性。方法: 将110例经血、尿中β2微球蛋白（β2-MG）检测证实具有早期肾功能损害的轻、中度高血压患者，随机分为3组，即伊贝沙坦组(A组,50例)：口服伊贝沙坦150~300 mg/d；依那普利组(B组,26例)：口服依那普利5~10 mg/d及伊贝沙坦加依那普利组(C组,34例)。所有入选病例均治疗12周，治疗前后测量血压并采用ELISA法检测血、尿中β2-MG的水平；采用彩色超声多普勒仪检查肾血流量及肾血管重构的情况。结果: 与治疗前相比较，治疗12周后3组患者的收缩压、舒张压均明显下降（P<0.01）；血、尿中β2-MG的水平明显降低（P<0.01）；肾阻力指数（RI）、搏动指数（PI）及平均流速（Vm）明显改善（P<0.01）。治疗后肾血管管壁的厚度及肾动脉的内径与治疗前有显著性差异（P<0.05）。伊贝沙坦与依那普利联合治疗组与单用伊贝沙坦或依那普利治疗组比较，血、尿中β2-MG的水平及肾血管重构指标有显著改善（P<0.01或P<0.05）。结论: 伊贝沙坦与依那普利联用对有早期肾功能损害的高血压患者，不仅有明显的降压作用，而且有明显改善肾功能的作用。

Abstract:: AIM: To evaluate the efficacy and safety of the combination of irbesartan and enalapril in treating renal damage in hypertensive patients. METHODS: A total of 110 patients with essential hypertension (EH) complicated with mild renal insufficiency were included in this study. Fifty cases were treated with irbesartan (150-300 mg/day), 26 cases were treated with enalapril (5-10 mg/day) and 34 cases were treated with a combination of irbesartan and enalapril for 12 weeks. Renal hemodynamics and structural variations and blood and urine microglobulin of β2-MG were determined before and after treatment by color Doppler ultrasonography and kit. RESULTS: After the combination treatment of irbesartan and enalapril, both systolic and diastolic pressure were significantly decreased (P<0.01). In groups A, B, and C, β2-MG in blood and urine were obviously decreased (P<0.01) and RI, PI and Vm were markedly decreased in left and right kidney after treatment. Thickness of renal arterial wall was significantly decreased and the renal arterial diameter was obviously increased (P<0.05). Compared with those in group C, blood and urine microglobulin of β2-MG and RI, PI and Vm were markedly decreased in left and right kidney after treatment. CONCLUSION: Irbesartan combined with enalapril was effective in lowering blood pressure, decreasing the concentration of β2-MG in blood and urine, decreasing renal arterial vessel resistance, increasing renal blood flow and improving renal vessel structure, thus improving renal function.

参考文献/References

［1］刘培良,陈瑶,李轩,等. 坎地沙坦和苯那普利治疗高血压病的对照研究［J］. 心脏杂志, 2007, 19(1):67-69.

［2］ Polónia J, Carmona J, Mendes E, et al. Prevalence of microalbuminuria in non-diabetic hypertensive patients attended by Portuguese GPs［J］. Rev Port Cardiol, 2007, 26(6):637-644.

［3］ Weir MR. Microalbuminuria and cardiovascular disease［J］. Clin J Am Soc Nephrol, 2007, 2(3):581-590.

［4］李朝晖，曹金安，朱平先. 苯那普利治疗肾性高血压的疗效观察［J］. 中华肾脏病杂志， 2000， 16（2）：84.

［5］朱平先, 黎明, 曹金安, 等. 伊贝沙坦对原发性高血压早期肾损害的影响［J］. 中华高血压杂志, 2005, 13（1）：28-31.

［6］ Pfeffer MA, McMurray JJ, Velazquez EJ, et al. Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both［J］. N Engl J Med, 2003, 349(20):1893-1906.

［7］ Maahs DM, Snell-Bergeon JK, Kinney GL, et al. ACE-I/ARB treatment in type 1 diabetes patients with albuminuria is associated with lower odds of progression of coronary artery calcification［J］. J Diabetes Compl, 2007, 21(5):273-279.

［8］ Hcht C, Gironacci MM, Mayer MA, et al. Involvement of angiotensin-(1-7) in the hypothalamic hypotensive effect of captopril in sinoaortic denervated rats［J］. Regul Pept, 2008, 146(1-3): 58-66

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伊贝沙坦与依那普利联用改善高血压病早期肾损害的观察

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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