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目的回顾性观察高选择性β1受体阻滞剂富马酸比索洛尔治疗既往使用美托洛尔或阿罗洛尔血压控制不佳的慢性肾脏病合并高血压患者的有效性及安全性。方法选择2013年1月至2014年9月四川大学华西医院肾脏内科3~5期慢性肾脏病高血压患者,经美托洛尔或阿罗洛尔治疗7 d以上血压控制仍不佳,更换为相似剂量的富马酸比索洛尔片治疗14 d,其他联合降压方案不变,共97例患者进行回顾性分析,评价换药前后诊室收缩压、舒张压、平均动脉压、心率等有效性评价指标及肝功能、肾功能、血糖、血脂、不良事件等安全性评价指标的变化情况。结果换用富马酸比索洛尔片14 d后,收缩压下降(19.8±12.6)mm Hg、舒张压下降(14.9±8.4)mm Hg、平均动脉压下降(16.4±8.9)mm Hg,心率下降(5.9±1.7)次/min(均P<0.01)。换药前后肾功能、肝功能、尿酸、血糖及血脂差异无统计学意义(均P>0.05)。结论对于既往使用美托洛尔或阿罗洛尔7 d以上血压仍控制不佳的3~5期慢性肾脏病合并高血压患者,换用等比剂量富马酸比索洛尔治疗可有效降低血压、心率,并具有良好的安全性。
Objective To retrospectively observe the effectiveness and safety of bisoprolol fumarate, a selective beta-1 blocker, in the treatment of hypertensive patients with chronic kidney disease who have not been properly controlled by metoprolol or arotinolol. Methods January 2013 to September 2014 West China Hospital of Sichuan University Department of Nephrology 3 to 5 patients with chronic kidney disease and hypertension, metoprolol or arotinol treatment for more than 7 days of blood pressure control is still poor, replaced by A similar dose of bisoprolol fumarate tablets for 14 days, the other combined antihypertensive regimen unchanged, a total of 97 patients were analyzed retrospectively, before and after dressing change assessment systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate and other effectiveness Evaluation index and liver function, renal function, blood glucose, blood lipids, adverse events and other safety evaluation index changes. Results After switched to bisoprolol fumarate for 14 days, systolic blood pressure (19.8 ± 12.6) mm Hg, diastolic blood pressure (14.9 ± 8.4) mm Hg, mean arterial pressure decreased (16.4 ± 8.9) mm Hg, heart rate decreased (5.9 ± 1.7) times / min (all P <0.01). Before and after dressing, renal function, liver function, uric acid, blood glucose and blood lipids were no significant difference (all P> 0.05). CONCLUSIONS: For patients with hypertensive disorder of chronic kidney disease stage 3-5 who still have poor control of blood pressure over 7 days after metoprolol or arotinolol, the switch to equivalent bisoprolol fumarate therapy may be effective in lowering blood pressure , Heart rate, and has good safety.