血管紧张素Ⅱ1型受体拮抗剂与血管紧张素转换酶抑制剂对老年高血压患者心肾功能影响的比较

The Effect of AngiotensinⅡAntagonist Losartan and Angiotensin Converting Enzyme Inhibitor Benazepril on Heart and Renal Functions in Elderly Patients with Essential Hypertension

目的 :探讨血管紧张素 (Ang) 受体拮抗剂—氯沙坦对老年高血压患者心肾靶器官功能的影响。 方法 :选择老年原发性高血压患者 6 0例 ,分为氯沙坦组 (n=30 )及苯那普利组 (n=30 ) ,观察用药前及用药 12周后患者的肾功能、超声心动图的改变。 结果 :氯沙坦组及苯那普利组肾功能异常者 2 4小时尿白蛋白、β2 微球蛋白、糖蛋白均有显著下降 (P<0 .0 1) ;左心室肥厚者左心室壁厚度、心肌重量指数下降 (P<0 .0 5 ) ,二尖瓣舒张早期血流峰值及舒张晚期血流峰值比增加 (P<0 .0 5 )。 结论 :氯沙坦可达到苯那普利同样的临床效应 ,两药均可减少尿蛋白量 ;

Objective:To investigate the changes of the function of heart and kidney after using angiotensin Ⅱ antagonist losartan and angiotensin convertion enzyme inhibitor(ACEI) benazepril in elderly patients with essential hypertension. Methods:Sixty patients with mild or moderate essential hypertension were divided into losartan group ( n= 30, 50 mg/d) and benazepril group ( n= 30,10 mg/d).Extra dihydrochlorothiazide 12.5 mg once a day was required if diastolic BP≥90 mmHg after 2 weeks.In both group,the result of renal function and echocardiography prior treatment were compared with those 12 weeks after treatment. Results:After 12 weeks of treatment,24 hour urinary protein excretions (albumin,β 2m protein and Tamm Horfall protein) reduced singnificantly ( p <0.01).Blood urea nitrogen.creatinine and glomerular filtration rate did not changed ( p >0.05).Intraventricular septum thickness,posterior wall thickness,left ventricular mass index and atiral peak filling velocity (Ap) were all decreased ( p <0.05) early peak filling velocity (Ep) and Ep/Ap ratio were increased ( p <0.05) in the left ventricular hypertrophy patients. Conclusion:Both losartan and benazepril can reduce urinary proetin excretions,ameliorate left ventricular hypertrophy and improve left ventricular diastolic function.