氯沙坦对老年高血压患者心肾功能的改善作用  

Effects of Losartan on cardiac and renal functions in elderly hypertensive patients

作　　者：马宝新[1] 吴绥生[1] 杨爱梅[1] 罗小圣[2] 

机构地区：[1]吉林大学第一医院干部病房,吉林长春130021 [2]吉林大学数学学院信息与计算系,吉林长春130012

出　　处：《吉林大学学报（医学版）》2005年第4期620-622,共3页Journal of Jilin University：Medicine Edition

基　　金：吉林省卫生厅资助课题(9731)

摘　　要：目的:观察氯沙坦对老年高血压患者心肾功能的影响。方法:选择43例老年高血压患者,口服氯沙坦50～100mg·d-1,治疗12～17个月,分别测定治疗前后左室重量指数(LVMI)、左室功能;肾血管结构及血、尿β2微球蛋白(β2MG)水平。结果:氯沙坦治疗后患者血压明显下降(P<0.001),左室重量(LVM)较治疗前明显减少(P<0.01),LVMI较治疗前明显减小(P<0.02),E/A较治疗前增加(P<0.01),等容舒张时间较治疗前缩短(P<0.05)。治疗后肾动脉管壁厚度明显变薄(P<0.01),动脉内径增宽(P<0.05);血β2MG的浓度降低、尿β2MG的排泄量明显减少(P<0.01)。结论:氯沙坦在有效降压的同时,可逆转左室肥厚,改善左室功能,尤以舒张功能为著,可降低肾动脉血管阻力,增加肾血流量,改善肾血管结构,降低尿β2MG排泄,改善肾脏功能。Objective To investigate the clinical effects of Losartan on ventricular and renal functions in elderly hypertensive patients. Methods Forty-three elderly hypertensive patients were treated with Losartan,50-100 mg·d^-1 for twelve to seventeen months ,left ventricular mass index (LWMI),left ventricular function, renal arterial structure, blood and urine β2-MG before and after treatment were determined. Results After treatment the blood pressure in patients had reduced effectively (P<0.001).LVM (P<0.01) and LVMI (P<0.02) were obviously reduced, E/A was increased(P<0.01).Thickness of renal arterial wall was significantly decreased (P<0.01),the renal arterial diameter was obviously increased (P<0.05), β2-MG levels in blood and urine were obviously decreased after treatment (P<0.01).Conclusion Losartan can effectively reduce blood pressure, it also can reverse left ventricular hypertrophy (LVH) and improve the function,especially the left ventricular diastolic function and increase the renal blood flow and improve the renal vessel structure, decrease the concentrations of β_2-MG in blood and urine ,and then improve renal function.

关 键 词：氯沙坦 高血压/药物疗法 心室功能 左 肾/病理学 肾动脉/病理学 超声检查 多普勒 

分 类 号：R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]