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目的探讨加倍剂量厄贝沙坦治疗老年高血压合并慢性肾脏病(CKD)患者的疗效和安全性。方法入选老年高血压合并CKD3期患者112例,随机分为常规剂量组(对照组)和加倍剂量组(观察组),对照组给予厄贝沙坦150mg/d,观察组给予厄贝沙坦300mg/d治疗,随访16周,观察治疗前后血压控制情况、24h尿蛋白和肾功能变化情况。结果随访16周,加倍剂量厄贝沙坦治疗使血压控制达标率由单倍剂量的18.2%增加至63.0%,并显著降低了24h尿蛋白[(2.16±0.86)比(1.65±0.58)g/24h,P<0.01],且两组治疗前后尿素氮、血肌酐、肾小球滤过率差异无统计学意义。结论对老年高血压合并CKD患者,加倍剂量厄贝沙坦具有更好的降压达标率和降尿蛋白作用。
Objective To investigate the efficacy and safety of doubled irbesartan in the treatment of elderly patients with hypertension and chronic kidney disease (CKD). Methods A total of 112 elderly hypertensive patients with CKD3 were randomly divided into two groups: normal control group and doubled dose group (observation group), control group received irbesartan 150 mg / d, and observation group received irbesartan 300 mg / d treatment, followed up for 16 weeks to observe the blood pressure control before and after treatment, 24h urine protein and renal function changes. Results After 16 weeks of follow-up, double-dose irbesartan treatment increased the compliance rate of blood pressure control from 18.2% to 63.0% and significantly reduced the urinary protein in 24 hours (2.16 ± 0.86 vs 1.65 ± 0.58 g / 24h, P <0.01]. There was no significant difference between the two groups before and after treatment of urea nitrogen, serum creatinine, glomerular filtration rate. Conclusion In elderly patients with hypertension and CKD, doubled dose of irbesartan has better antihypertensive effect and proteinuria.