氯沙坦与卡托普利治疗高血压肾病的临床效果比较

Comparisons of the clinical effect of Losartan and Captopril in the treatment of hypertensive nephropathy

目的 探讨氯沙坦与卡托普利治疗高血压肾病的临床效果。方法 选取2020年7月至2021年6月莆田市第一医院心血管内科收治的60例高血压肾病患者作为研究对象,采用随机抽签法将其分为氯沙坦组和卡托普利组,每组各30例。两组患者分别采用氯沙坦和卡托普利治疗高血压肾病。比较两组患者治疗前后的收缩压与舒张压、治疗前后估算的肾小球滤过率(eGFR)、治疗前后eGFR的差值(△eGFR)、治疗期间的不良反应总发生率。统计两组患者的血肌酐,并通过血肌酐估算eGFR。结果 治疗前,两组患者的收缩压、舒张压、eGFR比较,差异均无统计学意义(P>0.05)。治疗后,两组患者的收缩压均低于本组治疗前,且氯沙坦组低于卡托普利组,差异有统计学意义(P<0.05)。治疗后,两组患者的舒张压均低于本组治疗前,且氯沙坦组低于卡托普利组,差异有统计学意义(P<0.05)。治疗后,两组患者的eGFR均高于本组治疗前,且氯沙坦组高于卡托普利组,差异有统计学意义(P<0.05)。治疗后,氯沙坦组的△eGFR高于卡托普利组,差异有统计学意义(P<0.01)。氯沙坦组不良反应总发生率(13.30%)低于卡托普利组(36.70%),差异有统计学意义(P=0.037)。结论 从降压及改善肾功能的效果来看,卡托普利及氯沙坦两种药物均可有效降压和减轻肾功能损害,从而阻止肾病的进展。两种药物均能够降压,改善肾功能,降低药物不良反应发生率,氯沙坦治疗高血压肾病的效果优于卡托普利。

Objective To explore the clinical effects of Losartan and Captopril in the treatment of hypertensive nephropathy.Methods A total of 60 patients with hypertensive nephropathy admitted to the Department of Cardiology of the First Hospital of Putian From July 2020 to June 2021 were selected as the research subjects,they were divided into Losartan group and Captopril group by drawing lots method,with 30 cases in each group.Two groups of patients were treated with Losartan and Captopril respectively.The systolic and diastolic blood pressures,estimated glomerular filtration rate(eGFR),the difference between the eGFR(△eGFR)before and after treatment and the total incidence of complications during the treatment were compared between the two groups.The blood creatinine levels of the two groups were collected and were used for the calculations of the eGFR.Results Before treatment,there were no significant differences in systolic blood pressure,diastolic blood pressure,and eGFR between the two groups(P>0.05).After treatment,the systolic blood pressure of the two groups was lower than that before treatment,and the systolic blood pressure of the Losartan group was lower than that of the Captopril group,the differences were statistically significant(P<0.05).After treatment,the diastolic blood pressure of the two groups was lower than that before treatment,and the diastolic blood pressure of the Losartan group was lower than that of the Captopril group,the differences were statistically significant(P<0.05).After treatment,the eGFR of the two groups was higher than that before treatment,and the eGFR of the Losartan group was higher than that of the Captopril group,the differences were statistically significant(P<0.05).After treatment,△eGFR in the Losartan group was higher than that of the Captopril group,and the difference was statistically significant(P<0.01).The total incidence of the complications in the Losartan group(13.30%)was lower than that in the Captopril group(36.70%),the difference was significant(P=0.037).Conclusion From the effect of lowering blood pressure and improving renal function,both drugs can reduce blood pressure,improve renal function and reduce the incidence of adverse drug reactions,thereby preventing the progression of renal disease.Losartan is better than Captopril in the treatment of hypertensive nephropathy.