氯沙坦治疗原发性高血压的疗效和对尿清蛋白的影响

Efficacy and antiproteinuric effect of losartan in the treatment of essential hypertension

目的 探讨氯沙坦治疗轻、中度原发性高血压的疗效和对尿清蛋白的影响。方法 82例高血压患者随机分两组,氯沙坦组(治疗组,43例)50～100mg·d-1口服,疗程12周;培哚普利组(对照组,39例)4～8mg·d-1服,疗程12周。治疗前后做动态血压及肝、肾功能、血脂、血糖等检查,测定尿液中清蛋白(Alb),血清肌酐(Scr)及血尿素氮(BUN)的变化。结果 治疗组降压总有效率75％(33例),降压幅度(以mmHg计)收缩压(SBP)为21.舒张压(DBP)为13,谷/峰(T/P)比值SBP为0.73,DBP为0.71。对照组总有效率74％(29例),降压幅度SBP为22,DBP为12,谷/峰比值SBP为O.71,DBP为O.72,两组结果相似。治疗后两组尿Alb减低(P<0.01)。氯沙坦不良反应轻微。结论 氯沙坦对高血压有确切疗效,干咳发生率低,减少尿清蛋白的排泄,对肾脏有保护作用。

Objective To investigate the efficacy and antiproteinuric effect of losartan in the treatment of mild to moderate essential hypertension. Methods Fourty-three patients were given 50mg to 100mg of losartan once daily. Another 39 patients were given 4mg to 8mg of perindopril once daily. The course was 12 weeks. Ambulatory blood pressure monitoring(ABPM) .hepatic and renal function, albuminuria were examined before and after therapy. Results The total efficacy rate, amplitude of SBP and DBF lowered -and SBP and DBF trough to peak ratio(T/P)in losartan group were 75%. 21mmHg, 13mmHg, 0. 73 and 0. 71, respectively, While that in perindopril group was 74% ,22mmHg.l2mmHg,0. 71 and 0. 72, resspectively(P>0. 05). Both drugs appear to lower blood pressure adequately while inducing a decrease of urinary protein excretion. Conclusion Losartan is effective in patients with mild to moderate essential hypertension while reducing urinary protein excretion and incidence of cough. This profile has been hypothesized to be protective against progression of renal function decline.