作者：曾小林，黄敏强，韩伟，卢加发，林凡，姜亚娟，张倩，李海鹰

单位：

1.518055 广东省深圳市，深圳大学总医院心血管内科 2.518055 广东省深圳市，深圳大学总医院急诊科 3.518055 广东省深圳市，深圳大学总医院肾内科 通信作者：曾小林，E-mail：215742794@qq.com

Units：

1.Department of Cardiology, Shenzhen University General Hospital, Shenzhen 518055, China 2.Department of Emergency, Shenzhen University General Hospital, Shenzhen 518055, China 3.Department of Nephrology, Shenzhen University General Hospital, Shenzhen 518055, China Corresponding author: ZENG Xiaolin, E-mail: 215742794@qq.com

关键词：

高血压; 阿利沙坦酯; 贝尼地平; 血压; 肾功能; 血尿酸; 对比研究;

Keywords：

Hypertension; Allisartan isoproxil; Benidipine; Blood pressure; Renal function; Blood uric acid;Comparative study

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.018

Funds：

深圳市医疗卫生三名工程资助项目（SZSM201911007）；急救与创伤研究教育部重点实验室（海南医学院）开放课题基金（Grant.KLET-201905）

摘要：

背景近年研究发现,钙通道阻滞剂（CCB）贝尼地平具有降低尿蛋白的作用。血管紧张素Ⅱ受体拮抗剂（ARB）阿利沙坦酯是我国首个自主研发的1.1类抗高血压药。但目前有关贝尼地平与阿利沙坦酯治疗高血压的研究报道少见。目的比较阿利沙坦酯和贝尼地平对轻中度高血压患者降压效果、肾功能及血尿酸的影响。方法选取2020年1月至2021年6月深圳大学总医院心血管内科、肾内科门诊及住院部收治的新发高血压患者92例,采用随机数字表法分为阿利沙坦酯组（n=45）和贝尼地平组（n=47）。贝尼地平组患者给予贝尼地平治疗,阿利沙坦酯组患者给予阿利沙坦酯治疗。比较两组患者治疗前及治疗12周后24 h平均血压（包括24 h平均收缩压和24 h平均舒张压）、肾功能指标（包括血肌酐、血β2-微量蛋白、尿微量白蛋白/尿肌酐比值、尿总蛋白/尿肌酐比值）及血尿酸,并观察两组患者治疗期间不良反应发生情况。结果两组患者治疗前及治疗12周后24 h平均收缩压、24 h平均舒张压比较,差异无统计学意义（P> 0.05）;治疗12周后,两组患者24 h平均收缩压和24 h平均舒张压分别低于本组治疗前（P <0.05）。两组患者治疗前及治疗12周后血肌酐、血β2-微量蛋白、尿微量白蛋白/尿肌酐比值、尿总蛋白/尿肌酐比值、血尿酸比较,差异无统计学意义（P> 0.05）;治疗12周后,两组患者血肌酐、血β2-微量蛋白、尿微量白蛋白/尿肌酐比值、尿总蛋白/尿肌酐比值、血尿酸分别低于本组治疗前（P <0.05）。两组患者治疗期间均未出现明显不良反应。结论阿利沙坦酯与贝尼地平对轻中度高血压患者的降压效果及肾功能的改善效果相似,但对于轻中度高血压合并高尿酸血症患者推荐使用阿利沙坦酯。

Abstract：

【Abstract】　Background Recent studies have found that calcium channel blocker (CCB) benidipine can reduceurinary protein. Alisartan isoproxil, an angiotensinⅡ receptor antagonist (ARB) , is the first class 1.1 antihypertensive drugindependently developed in China. However, there are few reports on the treatment of hypertension by benidipine and alisartanisoproxil. Objective To compare the effects of allisartan isoproxil and benidipine on antihypertensive effect, renal function andblood uric acid in patients with mild to moderate hypertension. Methods From January 2020 to June 2021, 92 patients withnew onset hypertension diagnosed in the outpatient and inpatient in the Departments of Cardiology, Department of Nephrology ofShenzhen University General Hospital were selected, and they were divided into allisartan isoproxil group (n=45) and benidipinegroup (n=47) by random number table method. Patients in benidipine group were treated with benidipine and patients in alisartanisoproxil group were treated with allisartan isoproxil. The 24 hours mean blood pressure (including 24 hours mean systolicblood pressure and 24 hours mean diastolic blood pressure) and renal function indexes (including blood creatinine, blood β2-microprotein, urinary microalbumin/urinary creatinine ratio, urinary total protein/urinary creatinine ratio) and blood uric acidbefore treatment and 12 weeks after treatment were compared between the two groups, and the adverse reactions of the two groupsduring treatment were observed. Results There was no significant difference in 24 hours mean systolic blood pressure and 24hours mean diastolic blood pressure between the two groups before treatment and 12 weeks after treatment (P > 0.05) ; after 12weeks of treatment, the 24 hours mean systolic blood pressure and 24 hours mean diastolic blood pressure of the two groups werelower than those before treatment, respectively (P < 0.05) . There was no significant difference in the blood creatinine, blood β2-microprotein, urinary microalbumin/urinary creatinine ratio, urinary total protein/urinary creatinine ratio, blood uric acid betweenthe two groups before treatment and 12 weeks after treatment (P > 0.05) ; after 12 weeks of treatment, the blood creatinine, bloodβ2-microprotein, urinary microalbumin/urinary creatinine ratio, urinary total protein/urinary creatinine ratio, blood uric acidwere lower than those before treatment, respectively (P < 0.05) . Conclusion Allisartan isoproxil and benidipine have similarantihypertensive effect and improve effect of renal function in patients with mild to moderate hypertension, but allisartan isoproxilis recommended for patients with mild to moderate hypertension complicated with hyperuricemia.

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