氯沙坦的降压疗效及其对血压谷/峰比值的影响

Efficacy and influence of losartan on blood pressure T/P in patients with essential hypertension by ambulatory blood pressure monitoring

目的:以动态血压观察氯沙坦片对原发性高血压病患者的疗效及其对血压谷峰比值的影响。方法:60例原发性高血压病患者被随机均分为氯沙坦片组和苯那普利片组(各30例),分别给予氯沙坦片50～100mg和苯那普利片10～20mg,晨服,1次/日,疗程16周。结果:治疗后两组病人的血压均有明显下降,氯沙坦片组,收缩压(SBP)由治疗前的168.2±16.3 mmHg降至138.3±17.2mmHg,舒张压(DBP)由治疗前的99.8±8.1mmHg降至治疗后的85.3±6.4mmHg,SBP、DBP谷/峰比值分别为0.73和0.68;苯那普利组;SBP由治疗前的169.4±16.7mmHg降至139.3±16mmHg,DBP由治疗前的98.7±9.2mmHg降至治疗后的84.6±6.3mmHg,SBP、DBP谷/峰比值分别为0.67、0.63,与治疗前比较,P均<0.01,但组间比较差异不显著(P>0.05)。氯沙坦组无明显副作用,苯那普利组有6例出现咳嗽,2例咳嗽较剧烈,退出观察。结论:氯沙坦片能安全、有效、平稳地降低高血压病人的血压,其疗效与苯那普利疗效相似,但副作用明显少于后者,是高血压治疗的理想用药。

Objective: To evaluate the antihypertensive efficacy and influence of losartan on blood pressure (BP) T/P in patients with essential hypertension (EH) by ambulatory blood pressure monitoring. Methods: Sixty EH patients were enrolled randomly divided into losartan group (30 cases) and benazepril group (30 cases). Losartan (50-100 mg) was given to losartan group once/d for 16 weeks. Benazepril (10-20 mg) was given to benazepril group once/d for 16 weeks. Results: After treatment BP significantly decreased in both groups. SBP decreased from 168. 2±16. 3 mmHg to 138. 3±17. 2 mmHg, DBP decreased from 99. 8±8. 1 mmHg to 85. 3±6. 4 mmHg; T/P of SBP, DBP was 0. 73 and 0. 68 in losartan group. SBP decreased from 169. 4±16. 7 mmHg to 139. 3±16. 0 mmHg, DBP decreased from 98. 7 ± 9. 2 mmHg to 84. 6±6. 3 mmHg;T/P of SBP,DBP was 0. 67 and 0. 63 in benazepril group (compared with before treatment P<0. 01 all ). No significantly difference between two groups for BP (P>0. 05). There were no significant side effects in losantan group, but there was serve cough in 2 patients of benazepril group. Conclusion: Losartan is effective, safe and well tolerated in EH treatment. Its efficacy is analogous to that of benazepril but its side effects is less.