缬沙坦的降压和肾脏保护作用研究

Study on the antihypertensive and renoprotective effects of valsartan

目的 观察血管紧张素Ⅱ受体拮抗剂(ARB)缬沙坦对原发性高血压伴早期2型糖尿病肾病患者的降压效果和肾脏保护作用。方法 轻、中度原发性高血压伴早期2型糖尿病肾病患者入选本实验并随机分为缬沙坦组和培他乐克加安体舒通组。于4w末根据血压调整剂量和疗程,6m后对患者进行评价。结果 两组的降压及副作用相似。缬沙坦组和培他乐克加安体舒通组在治疗后24h尿白蛋白排泄率(24hUAER)水平和24hUAER的降低幅度有显著性差异(P<0.05)。其余指标无显著性差异(P>0.05)。结论 缬沙坦治疗轻、中度原发性高血压的有效率和培他乐克加安体舒通近似且耐受性好。作为一种强力高选择性的血管紧张素Ⅱ型受体拮抗剂,缬沙坦可以减慢早期2型糖尿病肾病蛋白尿的进展,并具有肾脏保护作用。

Objective To observe the efffects of angiotensin II receptor antagonist ( ARE) valsartan in decreasing blood pressure and protecting kidney to the patients suffering from mild-or-moderate hypertension companied with earlier type 2 diabetic nephropathy. Methods The patients suffering from mild-to-moderate hypertension and earlier type 2 diabetic nephropathy were divided into two groups. One of the groups were treated by valsartan, and the other were treated by Betaloc and Aldadinc. The period of the treatment and doses of the medicines were adjusted depending on the blood pressure 4 weeks later. The therapeutic effects of the two medicines were analyzed 6 months later. Results There were no differences in the effects of decreasing blood pressure and side-effects between the two groups. There were marked difference between the two groups in the post-treatment 24h urinary albumin excretion rate (24h UAER) and the variation of 24h UAER( P <0. 05 ). There was no significant difference in others parameters( P >0. 05 ). Conclusion Valsartan could prevent early proteinuria of type 2 diabetic nephropathy froming developping and protect the function of kidney.