氯沙坦治疗慢性肾小球肾炎蛋白尿的临床研究

①目的　探讨氯沙坦对原发性慢性肾小球肾炎蛋白尿患者肾脏的保护作用。②方法　将 68例患者血压控制于 1 4 0 90 mmHg以下 ,稳定 1周后随机分为两组。氯沙坦治疗组 34例 ,给予氧沙坦 50mg,每日 1次 ;苯那普利组 34例 ,给予苯那普利 1 0mg ,每日1次 ,疗程 1 2周 ,观察治疗前后血压、2 4小时尿蛋白、肾功能、血钾的变化及不良反应的发生情况。③结果　两组血压于治疗前后无显著变化 ,氯沙坦与苯那普利均能显著降低尿蛋白 ,治疗前后差异均有显著性 (P <0 .0 5) ,而两组间无显著性差异 (P >0 .0 5) ;对肾功能的影响 ,于第 4周结束时两组治疗均无明显改变 ,但在 1 2周结束时两组治疗前后均出现显著性差异 (P <0 .0 5) ,两组间比较 ,差异无显著性 (P >0 .0 5) ;氯沙坦能明显降低血尿酸 ,且无干咳、高血钾等不良反应。④结论　氯沙坦治疗慢性肾小球肾炎安全、有效 ,具有非降压依赖性降低蛋白尿、保护肾功能的作用。

The clinical study of losartan in treating proteinuria of chronic glimerulinephritis

Objective To investigate the clinical effects of losartan on renal function in patients with primary chronic glomerulinephritis. Methods Sixty-eight cases wiht primary chronic glmerulonephritis were randomly divided into 2 groups:losartan group(losartan 50mg,qd,n=34)and benazepril group(benazepril 10 mg qd,n=34),the blood pressure of all patients were controlled under 140/90mmHg before treatments. The treatment lasted for 12 weeks,and the parameters of blood pressure,proteinuria,serum uric acid,renal function and serum potassium were detected before and after treatment. Results The blood pressure had no significant changes in two groups before and after treatment. Both drugs can decrease the urinary protein ,but there was no significant difference between two groups (P>0.05). After 12w-treatment, there were significant influence on renal function in two groups(P<0.05).no significant difference was found between two groups. In losartan group,the adverse reaction was lower than that of benazepril group. Conclusions Losartan is effective and safe in treating proteinuria of primary chronic glomerulonephritis,and has renal protection effect.