两种AT_1拮抗剂治疗轻中度原发性高血压的临床研究  

Clinical Study on Treament of Mild to Moderate Essential Hypertension with. Two AT_1 Antsgoist

作　　者：曾群英[1] 麦炜颐[1] 何清[1] 陈国伟[1] 范毅敏[1] 

机构地区：[1]中山医科大学附属第一医院,广州510080

出　　处：《中国临床药理学杂志》2001年第3期182-185,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的：探讨缬沙坦和氯沙坦治疗轻中度原发性高血压的临床疗效及安全性。方法：１４５例轻中度原发性高血压患者随机分为两组，治疗组７４例，口服缬沙坦８０～１６０ｍｇ·ｄ－１，疗程半年；对照组７１例，口服氯沙坦５０－１００ｍｇ·ｄ－１，疗程半年。治疗前后测偶测血压、动态血压、肝肾功能、血脂、血糖、血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ（Ａμｇ Ⅱ）、醛固酮（ＡＬＤ）、内皮素（ＥＴ）等，观察心脑事件发生情况。结果：治疗组总有效率７６．１％（５６／７４），降压幅度２６．４／１５．２ｍｍＨｇ，谷／峰（Ｔ／Ｐ）比值：收缩压（ＳＢＰ）０．８２、舒张压（ＤＢＰ）０．８０；对照组总有效率７５．７％（５４／７１），降压幅度 ２６．１／１５．６ｍｍＨｇ， Ｔ／Ｐ比值： ＳＢＰ ０．８１、 ＤＢＰ ０．８０，均与对照组相似（Ｐ＞０．０５）。两组治疗后ＰＲＡ、 Ａμｇ Ⅱ均升高（Ｐ＜０．０５）； ＡＬＤ、 ＥＴ均降低（Ｐ＜０．０５），但组间对照无显著性差异（Ｐ＞０．０５）。血尿酸也明显下降（Ｐ＜０．０５），且基础值越高，降幅越大，对于治疗前高尿酸血症患者，对照组降低大于治疗组（Ｐ＜０．０５）。半年随访，两组心 脑血管事件发生率相似（Ｐ＞０．０５），治疗?OBJECTS: To explore the clinical efficacy and safety of treating mild to moderate essential hypertension with valsartan and losartan. METHOD: 145 cases were assigned into two groups randomly, one was treated with valsatan 80-160mg, another with losartan 50-100mg once daily for half a.year. Causal and ambulatory blood pressure, renal and hepatic function, plasma renin activity (PRA), plasma levels of angiotensin Ⅱ(Aug Ⅱ), aldosterone(ALD) and endothelin(ET) were ditermined before and after the therapy. Cardiocerebral events were monitored. RESULTS: The total effective rate, amplitude of blood Pressure reduced, TIP ratio of systolic and diastolic blood pressure in valsartan gruop were 76.l%(56174) 26.4/15.2mmHg, 0.82 and 0.78 respectively, and those of the losartan group were 75.7%(54/71);26. 1/15.6mmHg, o.8l and 0.80 respectively.The levels of PRA and Aug n elevated after the therapy(P<o.os), while those of ET decreased in both groups(P<0.05), there were no significant differences between two groups (P>0.05). The plasma level of uric acid also reduced after the treament in both groups(P<0.05), and the higher the level before treatment,the lower the amplitude reduced. The cardiocerebral events of two groups were similar in half a year's therapy. adverse reactions in valsartan group were mild. CONCLUSION: Valsartan is a new AT_1 antagonism which is safety, and has a long and steady antihynsive effect, also shows a good tolerant profile. It is worth recommening in clinical practice.

关 键 词：缬沙坦 氯沙坦 药物治疗 高血压 AT1拮抗剂 

分 类 号：R544.1[医药卫生—心血管疾病]