奥美沙坦酯对原发性高血压早期肾损害患者hs-CRP的影响

Effect of olmesartan medoxomil on hs-CRP level of hypertension with early renal damage

目的观察原发性高血压早期肾损害患者血清高敏C-反应蛋白(hs-CRP)的变化及奥美沙坦酯对其影响。方法根据24 h尿蛋白定量检测结果,将98例原发性高血压患者分为2组:单纯高血压组(56例)和肾损害组(42例)。同期选择45例健康体检者作为对照组。肾损害组给予奥美沙坦酯20～40 mg/d口服,12周后复查血清hs-CRP水平及24 h尿蛋白定量。结果对照组、单纯高血压组、肾损害组hs-CRP水平依次升高,高血压肾损害组血清hs-CRP水平明显高于单纯高血压组(P<0.05)。相关分析显示,hs-CRP水平与24 h尿蛋白定量呈正相关(r=0.51,P<0.05),奥美沙坦酯治疗后,患者血清hs-CRP水平及24 h尿蛋白定量较治疗前明显下降(P<0.01)。结论高血压病早期肾损害患者血清hs-CRP水平明显升高,提示炎症反应可能参与了高血压肾损害的病理生理过程,奥美沙坦酯通过抑制炎症反应发挥肾脏保护作用。

Objective To observe the changes of serum high-sensitivity C-reactive protein（hs-CRP） of essential hypertension with early renal damage and to assess the effects of olmesartan medoxomil on the level of serum hs-CRP. Methods According to the patients′ 24 h urine protein test results,98 cases of patients with essential hypertension were divided into two groups：simple hypertension group（n=56）and hypertensive renal damage group（n=42）.45 cases of healthy individuals served as normal control group during the same period.Olmesartan medoxomil 20～40 mg/d was given.After 12 weeks,the level of hs-CRP in serum was detected. Results The concentration of hs-CRP increased significantly in the order of normal control group,simple hypertension group and hypertensive renal damage group.The level of hs-CRP was positively related to the 24 h urine protein test result characterized by correlation analysis（r=0.51,P〈0.05）.Olmesartan medoxomi could significantly decrease the level of the serum hs-CRP and 24 h urine protein of hypertension with early renal damage（P〈0.01）. Conclusion The level of hs-CRP is significantly increased in the hypertensive patients with early renal damage,and it is positively correlated with the degree of renal damage induced by essential hypertension,which suggests that inflammation may play an important role in renal damage induced by essential hypertension.Olmesartan medoxomi can improve renal function of essential hypertension with early renal damage by inhibiting the inflammation reaction.