中国血液净化

中国血液净化 ›› 2012, Vol. 11 ›› Issue (3): 121-123.doi: 10.3969/j.issn.1671-4091.2012.03.00

• 临床研究 • 上一篇    下一篇

苯磺酸氨氯地平联合贝那普利对腹膜透析患者血压及血压变异性的影响

钟文旗 杨 林 倪 娜 李冰心 夏进标 武军驻   

  1. 武汉大学基础医学院生化教研室; 三峡大学第一临床医学院肾病科 湖北省宜昌市中心人民医院肾病科
  • 收稿日期:2011-08-10 修回日期:1900-01-01 出版日期:2012-03-12 发布日期:2012-03-12

The impact of amlodipine besylate combination with benazepril on blood pressure and blood pressure variability in peritoneal dialysis patients

ZHONG Wen-qi, YANG Lin, Ni Na, LI Bing-xin, XIA Jin-biao, WU Jun-zhu   

  • Received:2011-08-10 Revised:1900-01-01 Online:2012-03-12 Published:2012-03-12

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摘要： 【摘要】 目的 观察苯磺酸氨氯地平联合贝那普利对腹膜透析患者血压及血压变异性的影响。 方法   将165例高血压肾病或肾性高血压腹膜透析患者经过 2 周安慰剂导入期筛选出145例随机分为2组，治疗组80例：给予苯磺酸氨氯地平和贝那普利口服；对照组65例，对照组给予硝苯地平缓释片和贝那普利口服，治疗1月后随访血压24月，每1月随访1次，观察2组治疗前后血压、血压变异性的差异及心血管事件发生情况，包括心力衰竭(根据临床表现判断级NYHAⅡ 以上)，急性冠脉综合征(不稳定性心绞痛、急性心肌梗死、心源性猝死)。 结果 2组治疗前后血压及血压变异性比治疗前明显下降(P＜0.01），治疗组血压变异性降低幅度比对照组降低幅度大(P＜0.01）,两组间血压降低幅度没有显著性差异(P＞0.05），治疗后治疗组心血管事件发生率低于对照组(P＜0.01），心血管事件死亡率亦低于对照组(P＜0.01）。 结论 治疗组和对照组都能有效的控制腹膜透析患者的血压，但治疗组能有效的降低腹膜透析患者的血压变异性，从而降低腹膜透析患者心血管事件发生率及心血管事件死亡率。

关键词: 腹膜透析, 苯磺酸氨氯地平, 贝那普利, 血压变异性

Abstract: 【Abstract】 Objective To observe the impact of amlodipine besylate combination with benazepril on blood pressure and blood pressure variability in peritoneal dialysis patients. Methods A total of 145 peritoneal dialysis patients with hypertension were divided into two groups: treatment group (n=80) and control group (n=65). The treatment group was treated with amlodipine besylate and benazepril, and the control group with nifedipine sustained release tablet and benazepril. Follow-up of the patients lasted 24 months beginning from the treatment for one month. Comparisons were made for changes of blood pressure, blood pressure variability, and cardiovascular events including cardiac failure, acute coronary syndrome and sudden death between the two groups.  Results In the two groups, blood pressure and blood pressure variability were significantly decreased after the treatment (P＜0.01). Blood pressure variability was significantly lower in the treatment group than in the control group (P＜0.01), but the change of blood pressure was statistically insignificant between the two groups (P>0.05). The prevalence of cardiovascular events and cardiovascular mortality rate were significantly lower in the treatment group than in the control group (P＜0.01). Conclusion Amlodipine besylate combined with benazepril or nifedipine sustained release tablet combined with benazepril can efficiently control blood pressure in peritoneal dialysis patients. However, amlodipine besylate combination with benazepril was more effective in lowering blood pressure variability and thus the prevalence of cardiovascular events and cardiovascular mortality rate.

Key words: Peritoneal dialysis, Amlodipine besylate, Benazepril, Blood pressure variability