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目的 观察抑平舒降低血压、蛋白尿，延缓轻至中度慢性肾功能衰竭（ Ｃ Ｒ Ｆ） 进展的有效性和安全性。方法 轻、中度 Ｃ Ｒ Ｆ（ Ｓｃｒ １３４ ～３５４ μｍｏｌ／ Ｌ 或 Ｃｃｒ ３０ ～６０ ｍｌ／ｍｉｎ） 病人１１８ 例，其中慢性肾小球肾炎７１ 例，Ⅱ型糖尿病肾病５ 例，高血压肾小动脉硬化症３０ 例，多囊肾病３ 例，其他肾脏病９ 例。先依次选用倍他乐克、双氢克尿噻、心痛定控制病人血压，待血压及肾功能稳定后，根据 Ｃｃｒ将病人分为轻度 Ｃ Ｒ Ｆ组（ Ｃｃｒ４６ ～６０ｍｌ／ｍｉｎ） 和中度 Ｃ Ｒ Ｆ 组（ Ｃｃｒ ３０ ～４５ｍｌ／ｍｉｎ） ，每组病人再随机分为治疗组（ 抑平舒２ ．５ ～５ ．０ ｍｇ／ｑｄ ｎ ＝ ８０） 和对照组（ ｎ ＝ ３８） ，所有高血压病人继用上述降压药维持正常血压，随访期６ 个月。结果 治疗组治疗后收缩压平均下降１３ ｍｍ Ｈｇ（１ ｋ Ｐａ ＝ ７５ ｍ ｍ Ｈｇ） 、舒张压平均下降９５ ｍｍ Ｈｇ 和尿蛋白平均下降４０ ％ ，均较治疗前明显下降， Ｃｃｒ 明显增加；对照组治疗后收缩压、 Ｃｃｒ 明显下降， Ｓｃｒ、尿素明显增加，但舒张压和尿蛋白无明显差异，两组相比，治疗组降低血压、蛋白尿和延缓 Ｃ Ｒ Ｆ进展的作用明显优于对照组。?
Objective To observe the effectiveness and safety of the antihypertensive effect of lowering blood pressure and proteinuria, and delay the progress of mild to moderate chronic renal failure (C R F). Methods 118 patients with mild or moderate C R F (Scr 134 ~ 354 μmol / L or Ccr 30 ~ 60 ml / min), including 71 cases of chronic glomerulonephritis, 5 cases of type 2 diabetic nephropathy, hypertensive renal arterioles 30 cases of sclerosis, polycystic kidney disease in 3 cases, 9 cases of other kidney disease. The patients were divided into mild C R F (Ccr46 ~ 60ml / min) and moderate (Ccr46 ~ 60ml / min) according to Ccr after the first choice of metoprolol, hydrochlorothiazide and nifedipine were used to control the blood pressure. The patients in each group were randomly divided into treatment group (2.5-2.0 mg / qd n = 80) and control group (n = 38). All patients in the C R F group (Ccr 30-45 ml / min) Hypertensive patients continue to use the antihypertensive drugs to maintain normal blood pressure, follow-up period of 6 months. Results After treatment, systolic blood pressure decreased by 13 mm Hg (1 kPa = 75 m Hg), mean diastolic blood pressure decreased by 9.5 mm Hg and urinary protein decreased by 40%, both of which were significantly lower than those before treatment, while Ccr (P <0.05) .Conclusion Systolic blood pressure (Ccr), systolic blood pressure (Ccr), Scr and urea in control group increased significantly after treatment, but diastolic blood pressure and urinary protein had no significant difference between the two groups Obviously superior to the control group. ?