替米沙坦对原发性高血压病患者早期肾损害及肾内血液动力学的影响  

Effect of telmisartan on early renal function and intrarenal hemodynamics in essential hypertension patients

作　　者：孙亚非[1] 冯红旗[1] 张丽薇[1] 

机构地区：[1]哈尔滨医科大学疾病控制中心克山病研究所,黑龙江哈尔滨150081

出　　处：《哈尔滨医科大学学报》2012年第3期296-299,共4页Journal of Harbin Medical University

摘　　要：目的评价替米沙坦对原发性高血压病患者早期肾功能损害和肾内血液动力学的影响。方法选择80例原发性高血压,血肌酐(Cr)正常患者,分别测定Cr、血清胱抑素C(Cys-C)、尿白蛋白/血肌酐(Alb/Cr)来评价肾功能,用彩色多普勒超声仪测量肾动脉阻力指数(resistive index,RI)和搏动指数(pulsatility index,PI)评价肾内血液动力学。给予替米沙坦80～160 mg/d,12周后重复测量上述指标。结果治疗后收缩压及舒张压较治疗前明显降低(P<0.01);治疗前后血肌酐均没有变化,但血清胱抑素C(P<0.05)、尿白蛋白/血肌酐显著降低(P<0.01);治疗后微量白蛋白尿阳性患者的RI和PI降低(P<0.01)。结论 Cys-C、RI和PI是反映原发性高血压早期肾损害的指标。替米沙坦能降低肾动脉阻力,从而保护肾脏功能。Objective To evaluate the effect of telmisartan on early renal function and intrarenal hemodynamics in essential hypertension patients. Methods Eighty patients with primary hypertension and normal serum ereafinine （Cr） were studied. Cr, serum cystatin C （Cys-C）, urine protein/creatinine （Alb/Cr） were examined to evaluate renal function. Renal artery resistance index （RI） and pulsatility index（PI） were measured by color Doppler ultrasound to evaluate renal hemodynamics. Telmisartan 80 -160 mg/d was given, after 12 weeks, these index were measured again. Results Telmisartan reduced systolic and diastolic blood pressure significantly and decreased the Alb/Cr ratio （P 〈 0.01 ）. Cr had no change （P 〈 0.05 ）, Cys-C levels were significantly reduced（P 〈 0. 01 ）. Telmisartan decreased PI and RI in patients with microalbuminuria（P 〈 0. 01 ）. Conclusion Cys-C, RI and PI is sensitive indicators of early renal damage in essential hypertension, and telmisartan can significantly reduce renal vascular resistance to improve renal function in hypertensive patients.

关 键 词：原发性高血压 胱抑素C 阻力指数 搏动指数 替米沙坦 

分 类 号：R730.5[医药卫生—肿瘤]