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目的探讨运用依伦平治疗高血压合并肾损害患者疗效。方法选取在笔者所在医院门诊及住院的高血压合并肾损害患者90例(所选病例血肌酐<250μmol/L),随机分为依伦平组,厄贝沙坦组及氢氯噻嗪组各30例。依伦平组口服依伦平片150mg/次,1次/d,根据病情可增至每日1次,每次300mg。厄贝沙坦组单服厄贝沙坦片150mg/次.口服,1次/d,根据病情可增至每日1次,每次300mg。氢氯噻嗪组单服氢氯噻嗪片12.5mg/次,1次/d,3组疗程均为12周,治疗前后检测血压,24h尿蛋白、血尿酸、血尿素氮变化。结果治疗后以氢氯噻嗪组为对照组,依伦平组、厄贝沙坦组及两组间BUA及mALB均明显减低,差异有统计学意义(P<0.05);依伦平组与厄贝沙坦组的收缩压及舒张压减低明显,差异有统计学意义(P<0.05和P<0.01);依伦平组与厄贝沙坦组两组间治疗后血压变化差异无统计学意义,P>0.05。3组用药后无1例出现不良反应。结论依伦平(氢氯噻嗪+厄贝沙坦)可明显降低尿白蛋白、血清尿酸和降低收缩压、舒张压,其中降低舒张压更明显,能明显改善肾功能,而且用药安全。
Objective To investigate the curative effect of using Elanping in patients with hypertension and renal damage. Methods 90 patients (90 cases of serum creatinine <250μmol / L) were enrolled in the outpatient and hospitalized hypertensive patients with renal impairment. The patients were randomly divided into three groups: erenaline, irbesartan and hydrochlorothiazide. Elan flat oral oral Elan flat film 150mg / time, 1 / d, according to the disease can be increased to 1 day, each 300mg. Irbesartan group single-service irbesartan tablets 150mg / times.Oral, 1 / d, according to the disease can be increased to 1 day, each 300mg. Hydrochlorothiazide group single service hydrochlorothiazide tablets 12.5mg / time, 1 / d, 3 courses of treatment were 12 weeks, before and after treatment, blood pressure, 24h urine protein, serum uric acid, blood urea nitrogen changes. Results After treatment with hydrochlorothiazide as control group, the levels of BUA and mALB were significantly decreased in irinopan group, irbesartan group and the two groups, the difference was statistically significant (P <0.05) The systolic blood pressure and diastolic blood pressure were significantly reduced in the group of Tan and the difference was statistically significant (P <0.05 and P <0.01). There was no significant difference in the change of blood pressure between the two groups after treatment > 0.05.3 group after treatment without adverse reactions. Conclusion Erenzine (hydrochlorothiazide + irbesartan) can significantly reduce urinary albumin, serum uric acid and reduce systolic and diastolic blood pressure, which is more obvious to reduce diastolic blood pressure, can significantly improve renal function, and medication safety.