坎地沙坦酯对原发性高血压患者尿微量白蛋白的影响

Effects of Candesartan Cilexetil on Urine Microalbuminuria in Patients with Essential Hypertension

目的探讨坎地沙坦酯对原发性高血压患者的血压及尿微量白蛋白的影响。方法80例原发性高血压伴尿微量白蛋白患者随机分为两组:坎地沙坦组40例,口服坎地沙坦酯8～16mg/d;卡托普利组40例口服卡托普利37.5～150mg/d,疗程12周。分别测量两组治疗前后血压、尿微量白蛋白(ALB)、血肌酐(Scr)、尿肌酐并计算内生肌酐清除率(Ccr)。结果两组治疗后血压及尿微量白蛋白均显著下降(P<0.01),组间比较差异有统计学意义(P>0.05);两组治疗前后血肌酐、内生肌酐清除率均无明显变化(P>0.05)。卡托普利组咳嗽发生率27.5%,其中有6例不能耐受咳嗽而退出试验,坎地沙坦组无咳嗽病例发生。结论坎地沙坦酯不仅能有效降低血压,而且能降低尿微量白蛋白,与卡托普利疗效相似。

Objective To study the effects of Candesartan cilexetil on blood pressure and the urine microalbuminuria in patients with essential hypertension. Methods Eighty patients with essential hypertension were randomly divided into two groups. Candesartan cilexetil group （n =40） received Candesartan cilexetil 8 - 16mg/d for 12 weeks,and Captopril group （ n =34） received captopril 37. 5 - 150mg/d for 12 weeks. The serum creatinine, creatinine clearance rate and the urine microalbuminuria at the beginning and after 12 weeks of treatment were monitored. Results After treatment, blood pressure and the urine microalbuminuria significantly decreased in two groups （ P 〈 0. 01 ）. There was no significant difference between Candesartan cilexetil group and Enalaprol group （P 〉 0. 05）. The serum creatinine and creatinine clearance rate had no significant difference between Candesartan cilexetil group and Captopril group （P 〉 0. 05）. The occurrence of cough in captopril group was 27. 5% ,3 patients discontinued Captopril therapy due to serious cough. There was no cough patient in Candesartan cilexetil group. Conclusion Candesartan cilexetil not only reduced blood pressure but also decreased the levers of urine microalbuminuria, and had same protection effects on renal function compared with Captopril.