替米沙坦治疗原发性高血压的疗效观察

目的探讨替米沙坦（商品名：美卡素）和缬沙坦（商品名：代文）治疗轻中度原发性高血压的临床疗效和安全性。方法将126例轻中度原发性高血压患者随机分成两组各63例，替米沙坦组80mg／d，代文组160mg／d，早餐后顿服，疗程均8周。治疗前、后均进行血压、心率、血尿常规、肝肾功能、血生化、ECG及不良反应等检测。结果经8周治疗，替米沙坦组和代文组血压平均SBP由（156．3±13．1）mmHg分别降至（128．6±10．9，129．3±11．3）mm Hg；DBP由（98．3±11．6）mmHg分别降至（80．3±7．1，80．6±7．3）mmHg，较服药前均有显著降低（P〈0．01），总有效率分别为79．36％，73．02％。两组服药后同期疗效有明显差异（P〈0．05）。替米沙坦组总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL—C）水平由用药前的（5．6±1．2）mmol／L、（2．4±0．3）mmol／L、（3．3±0．4）mrnol／L分另U降为（4．9±1．1）mmol／L、（2．2±0．3）mmol／L、（2．9±0．5）mmol／L；高密度脂蛋白胆固醇（HDL一12）由用药前的（1．3±0．6）mmol／L上升为（1．5±0．3）mmol／L水平。而代文组仅TC由用药前的（5．6±1．2）mmo]／L下降至（5．2±1．3）mmol／L。两组治疗期间均未见明显不良反应。结论作为长效血管紧张素Ⅱ受体拮抗剂（ARA），替米沙坦和缬沙坦均是治疗轻中度原发性高血压的一线药物，疗效确切，安全可靠，耐受性好，不良反应少。但替米沙坦降压、降脂均优于缬沙坦，且半衰期（18～24h）更长，价格更低廉。

The Observation of Curative Effect for Telsartan In Curing Essential Hypertension

Objective To discuss the curative effect and safety issues of Telsartan(Micardis) and Valsartan (Diovan) Capsule in curing light and to moderate essential hypertension patients. Methods The 126 light or moderate essential hypertension patients were divided into two groups randonly:63 patients in Micardis group(80mg qd)and 63 patients in Diovan group(160mg qd). The courses of treatment of each group were 8 weeks. The medicine was taken by patients after breakfast everyday. Data of blood pressure, heart rhythm, blood and urine routine test, hepatic and renal function, blood biochemistry test, ECG and side effects was recorded everyday before and after the treatment. Results After 8 weeks treatment, the average SBP of blood pressure was reduced from ( 156.3 ± 13.3 ) mm Hg to(128.6 ± 10.9) mm Hg(Micardis group)and (129.3 ± 11.3) mm Hg(Diovan group). The average DBP was reduced from(98.3±11.6) mm Hg to(80.3±7.1) mm Hg(Micardis group)and(80.6 ±7.3) mm Hg(Diovan group). The blood pressure of both group had notable decreasing after taking medicine(P ＜ 0.01). The total effective rates were 79.36% and 73.02%. In the same term,the curative effect of both group have significant difference(P＜0.05). In Micardis group,total Cholesterol(TC) level reduced from(5.6 ± 1.2) mmol/L to( 4.9 ± 1.1 ) mmol/L; Triglyceride (TG) level reduced from (2.38 ± 0.31) mmol/L to (2.23 ± 0.33) mmoL/L; Low Density Lipoprotein Cholesterol(LDL-C) level reduced from( 3.26 ± 0.38 ) mmol/L to( 2.89 ± 0.46 ) mmol/L; High Density Lipoprotein Cholesterol (HDL-C) level increased from ( 1.3 ± 0.6 ) mmol/L to ( 1.5 ± 0.3 ) mmol/L. As comparison, in the Diovan group only the TC level reduced from (5.6 ± 1.2) mmol/L to(5.2 ± 1.3) mmol/L. Both groups did not have significant adverse reactions. Conclusion As the Angiotensin Ⅱ Receptor Antagonist ( ARA), both the Telsartan and Valsartan Capsule were effective medicines in curing light and moderate essential hypertension patients. These two medicines which were reliable and safety,had good tolerance and few side effects. However,Telsartan had better effects than Diovan in reducing blood pressure and triglyceride on light or moderate essential hypertension patients. Also, Telsartan had longer half-life period(18-24h) and lower price.