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【medical-news】ABC研究：钙通道三相阻滞剂降压降
Both strict blood pressure control and efferent artery dilatation are critical in reducing proteinuria, which in turn helps to regulate blood pressure. Benidipine, an L- and T-type calcium channel blocker, has the potential for increased effectiveness compared with L-type-dominant calcium channel blockers such as amlodipine.
Therefore, we evaluated blood pressure and proteinuria after changeover from amlodipine to benidipine in poorly controlled hypertensive patients. Fifty-eight hypertensive outpatients undergoing amlodipine treatment and unable to achieve optimal blood pressure as determined by Japanese Society of Hypertension Guidelines for the Management of Hypertention (JSH 2004) were changed over to benidipine treatment.
We measured blood pressure and pulse rate and assessed urinary protein excretion before and after changeover. Systolic and diastolic blood pressure dropped from 151/90 mmHg to 140/81 mmHg (p<0.0001). Mean blood pressure (p<0.0001) and pulse pressure (p=0.0069) were also reduced, but pulse rate increased from 75 bpm to 78 bpm (p=0.0047). Urinary protein excretion adjusted for urinary creatinine was reduced from 0.35 +/- 0.82 to 0.22 +/- 0.55 g/g creatinine (p=0.0119). The urinary protein reduction was observed only in patients with renin-angiotensin inhibition (p=0.0216). By switching from amlodipine to benidipine treatment, more than 80% of patients reduced their blood pressure, and more than 40% achieved optimal blood pressure. Higher urinary protein excretion (p<0.0001), lower glomerular filtration rate (p=0.0011) and presence of diabetes (p=0.0284) were correlated with reduction of urinary proteins during changeover.
Taken together, our results suggest that benidipine may have greater efficacy than amlodipine in reducing blood pressure and proteinuria.
http://www.docguide.com/news/content.nsf/PaperFrameSet?OpenForm&newsid=852571020057CCF6852573A1002F066A&topabstract=1&u=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=18037772 Renal-protective effect of T-and L-type calcium channel blockers in hypertensive patients: an Amlodipine-to-Benidipine Changeover (ABC) study.
T或L型的钙离子通道的阻滞剂在高血压患者中对肾脏的保护作用：氨氯地平－贝尼地平转换研究（ABC）研究
Both strict blood pressure control and efferent artery dilatation are critical in reducing proteinuria, which in turn helps to regulate blood pressure. Benidipine, an L- and T-type calcium channel blocker, has the potential for increased effectiveness compared with L-type-dominant calcium channel blockers such as amlodipine.
严格的血压控制和输出动脉滤过率都是降低蛋白尿的关键因素，而反过来蛋白尿的降低有助于血压的控制。贝尼地平，是L和T型的钙离子拮抗剂，和L型占优势的钙离子拮抗剂（如氨氯地平）相比，在降低蛋白尿方面更加有效。
Therefore, we evaluated blood pressure and proteinuria after changeover from amlodipine to benidipine in poorly controlled hypertensive patients. Fifty-eight hypertensive outpatients undergoing amlodipine treatment and unable to achieve optimal blood pressure as determined ，by Japanese Society of Hypertension Guidelines for the Management of Hypertention (JSH 2004) were changed over to benidipine treatment.
在血压控制不佳的患者中，我们用贝尼地平替代氨氯地平，而后评估换药后血压和蛋白尿。58名使用氨氯地平治疗的血压没有达到目标值的门诊病人，根据日本科学院的高血压指南，将氨氯地平换成贝尼地平。
We measured blood pressure and pulse rate and assessed urinary protein excretion before and after changeover. Systolic and diastolic blood pressure dropped from 151/90 mmHg to 140/81 mmHg (p<0.0001). Mean blood pressure (p<0.0001) and pulse pressure (p=0.0069) were also reduced, but pulse rate increased from 75 bpm to 78 bpm (p=0.0047). Urinary protein excretion adjusted for urinary creatinine was reduced from 0.35 +/- 0.82 to 0.22 +/- 0.55 g/g creatinine (p=0.0119). The urinary protein reduction was observed only in patients with renin-angiotensin inhibition (p=0.0216). By switching from amlodipine to benidipine treatment, more than 80% of patients reduced their blood pressure, and more than 40% achieved optimal blood pressure. Higher urinary protein excretion (p<0.0001), lower glomerular filtration rate (p=0.0011) and presence of diabetes (p=0.0284) were correlated with reduction of urinary proteins during changeover.
在替换用药的前后，我们分别测定患者的血压、脉率及尿蛋白清除。收缩压和舒张压从151/90 mmHg降低至140/81 mmHg (p<0.0001).平均动脉压(p<0.0001)和脉压(p=0.0069)也同时降低，但是脉搏却从75次/分上升至78次/分(p=0.0047)。已被尿肌酐效准过的尿蛋白清除从0.35 +/- 0.82降低至0.22 +/- 0.55 g/g肌酐(p=0.0119)。只在使用血管紧张素的患者中发现尿蛋白的降低(p=0.0216)。从氨氯地平换用贝尼地平后，80％的患者的血压降低，超过40％的患者血压达标。更高的尿蛋白清除(p<0.0001)，更低的肾小球滤过率(p=0.0011)，更少出现糖尿病(p=0.0284)和换药后的尿蛋白下降相关。
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作者:admin@医学,生命科学 2011-08-29 05:14
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