氯沙坦对原发性高血压患者血管内皮功能及肾功能的保护作用

目的:观察氯沙坦对原发性高血压患者血管内皮功能及肾功能的保护作用。方法:对40例轻、中度原发性高血压患者(观察组),予以氯沙坦片50mg,qd,口服,血压下降不理想增加至100mg,qd,连用16周。观察治疗前、后患者血压变化,并检测肱动脉内皮舒张功能(FMD)及尿微量白蛋白(U-MALB)、β2-微球蛋白(β2-MG)含量的变化和不良反应。另选30例健康体检者作为对照组。结果:治疗前,观察组患者肱动脉FMD较对照组明显降低,尿U-MALB和β2-MG含量均较对照组明显升高(均P<0.01);经氯沙坦治疗16周后,观察组患者收缩压和舒张压均控制正常,肱动脉FMD较治疗前明显升高,尿U-MALB和β2-MG含量均较治疗前明显降低(均P<0.01)。但与对照组比较,差异仍有统计学意义(P<0.05)。治疗过程中未见明显不良反应发生。结论:原发性高血压患者存在血管内皮功能障碍和肾脏功能损害,氯沙坦具有良好降压效果,有改善原发性高血压患者内皮功能和保护肾功能作用。

Protective Effects of Losartan on Endothelial and Kidney Functions in Patients with Essential Hypertension

OBJECTIVE:To investigate the protective effect of losartan on endothelial and kidney functions in patients with essential hypertension.METHODS:40 patients with mild or moderate primary hypertension(observation group) were given losartan 50 mg·d-1 orally to 100 mg·d-1 if the blood pressure was not controlled well for 16 weeks.The changes of blood pressure were observed before and after therapy.The changes of FMD,U-MALB level,β2-MG content and ADR were determined.30 healthy people were set as control group.RESULTS:The level of FMD in observation group was significantly lower than in control group,but the levels of U-MALB and β2-MG were opposite(both P<0.01).16 weeks after treatment,the systolic and diastolic pressure of observation group were controlled well,and the FMD increased significantly than pre-therapy,but the levels of U-MALB and β2-MG were opposite(all P<0.01),and increased significantly than control group(P<0.05).No ADR was found during treatment.CONCLUSIONS:There are dysfunction of endothelial and kidney in patient with essential hypertension.Losartan can well decrease the blood pressure,improve the endothelial and kidney function.