【摘要】 目的　评估氯沙坦治疗对高血压病人肾功能的影响。方法　 47例高血压病病人随机分为两组 :氯沙坦组(5 0mg ,1次 /日 ,2 3例 ) ;依那普利组 (10mg,1次 /日 ,2 4例 )。若经 2周治疗后 ,舒张压仍超过 90mmHg ,则剂量加倍。疗程8周。治疗前后观察血压及肾功能指标变化 ,并进行比较。结果　①两组经治疗后血压均明显降低 ,氯沙坦组由 (16 4 7± 14 9/ 10 1.2± 6 .1)mmHg降至 (145 .7± 9.7/ 87.5± 7.2 )mmHg ,P均 <0 .0 1;依那普利组由 (16 4 2± 14 4/ 10 1.5± 5 .1)mmHg降至 (142 .7± 8.6 / 87.0± 6 .0 )mmHg ,P均 <0 .0 1。②两组的尿系列微量蛋白也明显降低 ,氯沙坦组 [2 4小时尿白蛋白 (mg/ 2 4h) :2 4.0 5± 16 .6 3降至 16 .0± 7.0 9,尿 β2 微球蛋白 (mg/L) :0 .30 4± 0 .0 89降至 0 .2 41± 0 .0 71;尿视黄醇结合蛋白 (μg/L) :312 .1± 10 8.7降至 2 2 4.4± 85 .1;P均 <0 .0 5 ];依那普利组 [2 4小时尿白蛋白 (mg/ 2 4h) :2 1 96± 11.2 0降至13 78± 7.2 7;尿β2 微球蛋白 (mg/L) :0 .2 98± 0 .0 88降至 0 2 30± 0 .0 6 9;尿视黄醇结合蛋白 (μg/L) :30 6 .1± 10 5 .9降至 2 17.9± 80 .1;P <0 .0 5 ];两组之间比较无显著差异性 (P >0 .0 5 )。③治疗后 ,两组的尿系列微量蛋白下降幅?更多还原

【Abstract】 Objective To investigate the effects of losartan on renal function in patients with essential hypertension. Methods 47 patients with mild-moderate hypertension were randomly allocated to receive active treatment with losartan 50 mg daily (n=23) or enalapril 10 mg daily (n=24) for 8 week period. The doubling of dose was performed if diastolic blood pressure (DBP) was >90 mmHg after two weeks of treatment. Blood pressure measurements as well as parameters of renal function at the before and after active treatment were compared.Results ①Sitting blood pressure was similarly reduced in both treatments. Losartan: from (164.7±14.9/101.2±6.1)mmHg to (145.7±9.7/87.5±7.2)mmHg, enalapril:from (164.2±14.4/101.5±5.1)mmHg to (142.7±8.6/87.0±6.0)mmHg, both P <0.01. ②Serial microproteinuria; significantly reduced during losartan [urinary albumin excretion (mg/24h):(24.05±16.63)vs(16.0±7.09); urinary β 2 microglobulin excretion (mg/L):(0.304±0.089)vs(0.24±0.071); urinary retinal binding protein excretion (μg/L):(312.1±108.7)vs(224.4±85.1); both P<0.05]; as well as enalapril [urinary albumin excretion (mg/24 h):(21 96±11.20)vs(13.78±7.27); urinary β 2 microglobulin excretion (mg/L):(0.298±0.088)vs(0.233±0.069); urinary retinal binding protein excretion (μg/L):(306.1±105.9) vs (217.9±80.1); both P<0.05]. No difference was observed between two groups. ③ No significant correlation in the decreasing magnitude of microproteinuria excretion and SBP or DBP between both groups. Glucose, lipid, urea nitrogen, creatinine and live enzyme were unchanged during both treatments. Conclusion Losartan and enalapril have shown the equal effects reducing blood pressure in essential hypertensive patients. No adverse effects were seen on glucose, lipid and liver enzyme concentrations. Losartan treatment reduces microproteinuria at least as effectively as enalapril, suggesting that microproteinuria excretion is profoundly affected by the angiotensin Ⅱ.更多还原