双倍剂量氯沙坦治疗IgA肾病中蛋白尿疗效评价  

Therapeutic Evaluation of Double-Dose Losartan on Albuminuria in Patients with IgA Nephropathy

作　　者：张春霞[1] 郭一丹[1] 孙蔚明[1] 田茹[1] 贾萌[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院肾内科,北京100038

出　　处：《现代生物医学进展》2013年第33期6489-6491,共3页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(81172440)

摘　　要：目的:探讨双倍剂量氯沙坦氯沙坦在IgA肾病(IgA nephropathy,IgAN)中降低蛋白尿的临床疗效。方法:选取40例经肾穿刺病理诊断为IgAN的患者,随机分为2组,A组18例采用单剂量(50 mg,qd)氯沙坦;B组22例用双倍剂量(100 mg,qd)氯沙坦,观察8周后两组的血压、实验室指标:血肌酐、尿素氮、血钾、24 h尿蛋白、内生肌酐清除率(creatinine clearance rate,CCr)等以及临床症状,并作安全性评价。结果:B组患者24 h蛋白尿下降(0.91±0.33g/24h),A组患者蛋白尿下降(0.21±0.22g/24h),B组24 h蛋白尿下降率明显高于A组(P<0.05)。双倍剂量氯沙坦在IgAN治疗中未出现不良反应,包括高血钾、咳嗽、低血压或水肿等。结论:双倍剂量氯沙坦在治疗IgAN中降蛋白尿的疗效较单剂量明显,应用安全,耐受性好,无明显不良反应。Objective： To explore the clinical efficacy of double-dose losartan on albuminuria in patients with IgA nephropathy （I- gAN）. Methods： 40 patients diagosed with IgAN acorrding to renal biopsy were selected and randomly divided into 2 groups, A group （n=18, 50 mg losartan daily） and B group （n=22, double-dose of 100 mg losartan daily）. The blood pressure, laboratory index, including blood creatinine, urea nitrogen, blood potassium, 24 h urine protein, creatinine clearance rate （CCr） etc., as well as clinical symptom and the evaluation ofsafly were compared between the two groups. Results： 24 h urine protein in B group was decreased to （0.91 ± 0.33g/24h） and was decreased to 0.21± 0.22 g/24 h in A group. The decrease rate of 24 h urine protein in B group was significantly higher than that in A group （P〈0.05）. No side effect was found in double-dose losartan treatment on IgAN, including high blood potassium, cough, low blood pressure or edema. Conclusion： Double-dose losartan treatment is more effecive than single-dose treatment, safe, well tolerated and has no obvious side effect.

关 键 词：IGA肾病 氯沙坦 蛋白尿 

分 类 号：R692[医药卫生—泌尿科学]