氯沙坦治疗慢性肾功能不全伴高血压20例观察

目的　评价氯沙坦在治疗慢性肾功能不全伴高血压时对肾脏的保护作用。方法　 40例慢性肾功能不全伴高血压患者 ,2 0例接受氯沙坦 (Los)治疗 ,2 0例接受苯那普利 (Ben)治疗 ,对照观察 4周。治疗前后测血压、肾功能、内生肌酐清除率、2 4h尿蛋白定量。结果　Los与Ben组的降压有效率分别为 95 %、90 % ,但差异无显著性(P >0 .0 5 )。两组治疗前后血清肌酐、尿素氮及内生肌酐清除率均无明显变化。氯沙坦可降低血尿酸水平 ,与治疗前对照有显著差异 (P <0 .0 1) ;苯那普利不影响血清尿酸。两组治疗后 2 4h尿蛋白均较治疗前减少 (P <0 .0 5 )。氯沙坦不良反应轻微。结论　氯沙坦对高血压患者慢性肾功能代偿与失代偿期有效 ,且副作用小 ,与利尿剂合用其降压效果可增强 ;氯沙坦有肾脏保护作用。

Effects of Losartan on Treatment of Chronic Renal Impairment

Objective To evaluate the renal protective effects of losartan in treatment of chronic renal impairment.Methods Forty patients were divided into two groups:20 patients treated with losartan (50mg,qd),20 patients treated with benazepril (10mg,qd),all groups were treated for 4 weeks.Blood pressure,renal function,creatinine clearance and the protein excretion rates were examined before and after therapy.Results According to blood pressure measurment the overall efficacy rate of losartan and benazepril was 95% and 90% respectively.No statistical singnificant difference between two groups was found ( P >0.05).Creatinine clearance,blood creatinine and uria nitrogen were not increased in losartan and benazepril groups.Losartan had an effect on decreasing urine acid after the therapy ( P <0.05),while benazepril had no effect.Fixed quantity of urinary protein in 24 hours decreased after the therapy in both groups ( P <0.05).The adverse reaction of losartan was mild.Conclusion Losartan is effective and safe in treatment of mild and moderate chronic renal impairment.It reveals synergistic action when used with uragogue.Losartan has a good renal protective effect.