坎地沙坦与氯沙坦治疗原发性高血压的疗效及对肾脏的保护作用  

Effect of candesartan and losartan on essential hypertension patients and the protective effect on renal function

作　　者：方晓江[1] 钱宝庆[1] 

机构地区：[1]浙江省杭州市中医院心内科,杭州310007

出　　处：《实用药物与临床》2014年第6期688-691,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的比较坎地沙坦与氯沙坦治疗原发性高血压的临床疗效及对肾脏的保护作用。方法将本院诊治的72例轻中度原发性高血压病患者随机分为坎地沙坦组与氯沙坦组,两组分别给予坎地沙坦口服,8 mg/d,氯沙坦50 mg/d,疗程8周。比较两组治疗前后24 h动态血压改变、心率震荡初始值(TO)、心率震荡斜率(TS)及肾功能指标的变化。结果坎地沙坦组与氯沙坦组治疗有效率分别为84.2%和82.4%,两组比较差异无统计学意义(P>0.05);坎地沙坦组治疗后24 h收缩压(SBP)及24 h舒张压(DBP)分别为(121.45±10.23)mmHg和(76.24±6.03)mmHg,氯沙坦组分别为(122.39±10.16)mmHg和(76.53±6.21)mmHg,两组比较差异无统计学意义(P>0.05),但坎地沙坦组清晨血压SBP及DBP下降值分别为(13.90±3.32)mmHg和(9.80±2.17)mmHg,显著优于氯沙坦组(10.23±2.87)mmHg和(7.33±2.01)mmHg(P<0.05);坎地沙坦组与氯沙坦组治疗后TO分别为(0.38±0.23)%、(0.40±0.25)%,TS为(5.16±0.83)ms/RRI、(5.09±0.78)ms/RRI,差异无统计学意义(P>0.05);坎地沙坦组治疗后24 h尿蛋白及尿β2-MG分别为(134.90±19.21)mg和(1.88±0.43)mmol/L,氯沙坦组分别为(136.73±18.70)mg和(1.87±0.41)mmol/L,两组均显著优于治疗前(P<0.05);两组治疗后BUN、SCr与治疗前比较差异无统计学意义(P>0.05);氯沙坦组治疗后尿酸水平显著低于坎地沙坦组(312.20±18.93)vs(339.84±18.74)μmol/L,P<0.05。结论坎地沙坦与氯沙坦治疗轻中度高血压均有较好疗效,对肾脏具有保护作用。但坎地沙坦控制清晨血压效果更为理想,氯沙坦可显著降低尿酸水平,临床可根据患者病情选用药物。Objective To compare the effect of candesartan and losartan on essential hypertension patients and the protective effect on renal. Methods 72 patients with mild to moderate hypertension were randomly divided into candesartan group and losartan group. The two group received candesartan 8 mg /d or losartan 50 mg /d for 8 weeks. Ambulatory blood pressure,TO,TS and renal function index were compared between the two groups. Results Effective rate of candesartan group and losartan group were 84. 2% and 82. 4% respectively（ P 〉0. 05）. After treatment,24-hour SBP and DBP values of candesartan group were（ 121. 45 ± 10. 23） and（ 76. 24 ± 6. 03） mmHg,and of which were（ 122. 39 ±10. 16） and（ 76. 53 ± 6. 21） mmHg in losartan group,there were no significant difference of 24-hour SBP and DBP values between the two groups（ P 〉0. 05）; Decrease value of morning SBP and DBP were（ 13. 90 ± 3. 32） and（ 9. 80 ± 2. 17）mmHg in candesartan group,and（ 10. 23 ± 2. 87） and（ 7. 33 ± 2. 01） mmHg in losartan group（ P〈0. 05）; In candesartan group and losartan group,TO were（ 0. 38 ± 0. 23） % and（ 0. 40 ± 0. 25） %,and TS were（ 5. 16 ± 0. 83） and（ 5. 09± 0. 78） ms /RRI respectively without significant difference between the two groups（ P〉 0. 05）; After treatment,24 h urine protein and urine β2-MG were（ 134. 90 ± 19. 21） mg and（ 1. 88 ± 0. 43） mmol /L in candesartan group and（ 136. 73± 18. 70） mg and（ 1. 87 ± 0. 41） mmol /L in losartan group,of which were superior to pre-treatment in the two groups（ P〈0. 05）. There were no significant difference of BUN and Scr before and after treatment in the two groups（ P〈0. 05）;After treatment,purine trione in losartan group was much lower than that in candesartan group（ 312. 20 ± 18. 93） vs（ 339.84 ±18.74） μmol/L,P 0.05. Conclusion Candesartan and losartan treatment for mild to moderate hypertension patients both have ideal anti-hypertension effect and protective effect on renal functi

关 键 词：原发性高血压 坎地沙坦 氯沙坦 肾功能 

分 类 号：R544.1[医药卫生—心血管疾病]