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目的观察贝那普利联合螺内酯对非腺瘤型原发性醛固酮增多症的临床疗效与安全性。方法 68例非腺瘤型原发性醛固酮增多症患者随机分为对照组34例与试验组34例,2组均给予常规治疗及对症治疗。对照组口服硝苯地平缓释片40 mg,每日1次,进食时或餐后口服螺内酯20 mg,每日3次;试验组口服盐酸贝那普利片10 mg,进食时或餐后口服螺内酯20 mg,每日3次。2组患者1个周期均为28 d,共治疗3个周期。比较2组患者的临床疗效、治疗前后血压、左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、6 min步行距离、24 h尿蛋白及药物不良反应发生情况。结果治疗后,对照组临床总有效率为76.47%(26/34例),试验组为88.24%(30/34例),差异无统计学意义(P>0.05)。治疗后,试验组的收缩压为(140.46±14.27)mm Hg,舒张压为(88.57±8.94)mm Hg,LVEDD为(41.58±4.25)mm,LVESD为(38.47±3.98)mm,24 h尿蛋白为(1.30±0.14)g·d~(-1);对照组的收缩压为(148.35±14.94)mm Hg,舒张压为(96.57±10.57)mm Hg,LVEDD为(48.57±4.96)mm,LVESD为(45.47±4.68)mm,24 h尿蛋白为(1.67±0.17)g·d~(-1)(P<0.05)。试验组LVEF为(50.46±5.15)%,6 min步行距离为(504.58±51.68)m;对照组LVEF为(41.54±4.36)%,6 min步行距离为(450.57±46.48)m,差异有统计学意义(P<0.05)。药物不良反应以胃肠道反应、肌肉酸痛为主,对照组药物不良反应发生率为14.71%(5/34例),试验组为8.82%(3/34例),差异无统计学意义(P>0.05)。结论贝那普利联合螺内酯对非腺瘤型原发性醛固酮增多症的临床疗效显著,安全性高。
Objective To observe the clinical efficacy and safety of benazepril in combination with spironolactone against non-adenoma of primary aldosteronism. Methods Sixty-eight patients with non-adenomatous primary aldosteronism were randomly divided into control group (34 cases) and experimental group (34 cases). Both groups were given routine treatment and symptomatic treatment. The control group was given oral nifedipine sustained-release tablets 40 mg once daily, spironolactone 20 mg orally or after meals 3 times daily, and the test group was orally administered with benazepril hydrochloride tablets 10 mg orally or after meals Spironolactone 20 mg, 3 times a day. One cycle of two groups of patients were 28 days, a total of three cycles of treatment. The clinical efficacy, blood pressure, left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic dimension (LVEDD), walking distance 6 min, urinary protein and drug 24 h Adverse reactions occurred. Results After treatment, the total effective rate in the control group was 76.47% (26/34 cases) and 88.24% (30/34 cases) in the experimental group, with no significant difference (P> 0.05). After treatment, the systolic blood pressure (SBP) was (140.46 ± 14.27) mm Hg, the diastolic blood pressure was (88.57 ± 8.94) mm Hg, the LVEDD was (41.58 ± 4.25) mm, the LVESD was (38.47 ± 3.98) (1.30 ± 0.14) g · d -1 .The systolic blood pressure of the control group was (148.35 ± 14.94) mm Hg, the diastolic pressure was (96.57 ± 10.57) mm Hg, the LVEDD was (48.57 ± 4.96) mm, the LVESD (45.47 ± 4.68) mm, and the urinary protein in 24 hours was (1.67 ± 0.17) g · d -1 (P <0.05). The LVEF was (50.46 ± 5.15)% in the trial group and (504.58 ± 51.68) m in the 6 min group. The LVEF in the control group was (41.54 ± 4.36)% and the walking distance was (450.57 ± 46.48) Significance (P <0.05). Adverse drug reactions gastrointestinal reactions, muscle soreness, the incidence of adverse drug reactions in the control group was 14.71% (5/34 cases), the experimental group was 8.82% (3/34 cases), the difference was not statistically significant (P > 0.05). Conclusion The combination of benazepril and spironolactone has significant clinical effect on non-adenomatous primary aldosteronism with high safety.