氯沙坦与福辛普利、卡托普利对老年高血压患者肾功能保护的对比临床研究

A Comparison Between The Effects of Losartan and Fosinopril,Captopril on The Excretive Rate of Urinary Albumin and The Clearance of Endogenous Creatinine in Elderly Hypertensive Patients

目的观察氯沙坦和与福辛普利、卡托普利对老年高血压病人尿白蛋白排泄量(UAER)与内生肌酐清除率(CrC)的影响,比较3种药物对老年高血压患者肾功能保护作用的差别。方法选择162例老年高血压病2～3级患者,UAER在20～400mg/24h。CrC在31～51mL/min1.73m-2之间,按序数分成均等3组:氯沙坦组、福辛普利组、卡托普利组,平均3周。进行治疗前后肾功能保护作用对比研究。结果氯沙坦治疗老年人高血压病的临床效果同福辛普利以及卡托普利一样有效,3种药物降压总有效率分别为94%、93%、93%(P>0.05)。但氯沙坦与福辛普利对老年高血压患者肾功能保护作用明显好于卡托普利,3组比较有显著差异性。结论氯沙坦除有良好的降压作用外,尚具有更好地保护老年高血压患者肾功能作用。

ObjectiveTo evaluate the effects of losartan, fosinopril and captopril on the excretive rate of urinary albumin(UAER) and the clearance of endogenous creatinine (Cr-C) in elderly hypertension patients.MethodsIn this study, 162 elderly patients with 2～3 grade hypertension were enrolled.The patients were divided into 3 groups which treated with losartan (mean dosage 240 mg/d, n=54) and the fosinopril (248 mg/d, n=54) , and captopril (245 mg/d, n=54) for average three weeks.The anti-hypertensive effect and UAER and Cr-C were determined before and after the treatment. ResultsThe response rates were 94% in losartan group and 93%, 93% in fosinopril group, captopril group(P>0.05).Rate of decrease of UAER were 89% in Losartan group which was much better than that of 59% and 50% in fosinopril group and captopril group (P<0.01).Rate of Cr-C improvement was 94% in losartan group better than 78% in fosinopril group and 63% in captopril group.ConclusionAlthough no difference in the antihypertensive respone rate was found in the losartan, fosinopril, and captopril groups.Losartan has been shown obviously better effects on UAER and Cr-C than that by captopril and fosinopril in elderly hypertension patient.