CAJ | 학술논문

目的：比较坎地沙坦与氯沙坦治疗原发性高血压的临床疗效及对肾脏的保护作用。方法将本院诊治的72例轻中度原发性高血压病患者随机分为坎地沙坦组与氯沙坦组,两组分别给予坎地沙坦口服,8 mg/d,氯沙坦50 mg/d,疗程8周。比较两组治疗前后24 h动态血压改变、心率震荡初始值( TO)、心率震荡斜率( TS)及肾功能指标的变化。结果坎地沙坦组与氯沙坦组治疗有效率分别为84．2%和82．4%,两组比较差异无统计学意义( P>0．05)；坎地沙坦组治疗后24 h 收缩压( SBP )及24 h 舒张压( DBP )分别为(121．45±10．23)mmHg和(76．24±6．03)mmHg,氯沙坦组分别为(122．39±10．16)mmHg和(76．53±6．21)mmHg,两组比较差异无统计学意义( P>0．05),但坎地沙坦组清晨血压 SBP 及 DBP 下降值分别为(13．90±3．32) mmHg 和(9．80±2．17)mmHg,显著优于氯沙坦组(10．23±2．87)mmHg 和(7．33±2．01)mmHg (P<0．05)；坎地沙坦组与氯沙坦组治疗后 TO分别为(0．38±0．23)%、(0．40±0．25)%, TS为(5．16±0．83) ms/RRI、(5．09±0．78) ms/RRI,差异无统计学意义(P>0．05)；坎地沙坦组治疗后24 h尿蛋白及尿β2-MG分别为(134．90±19．21)mg和(1．88±0．43)mmol/L,氯沙坦组分别为(136．73±18．70)mg和(1．87±0．41)mmol/L,两组均显著优于治疗前(P<0．05)；两组治疗后BUN、SCr与治疗前比较差异无统计学意义(P>0．05)；氯沙坦组治疗后尿酸水平显著低于坎地沙坦组(312．20±18．93)vs (339．84±18．74)μmol/L,P<0．05。结论坎地沙坦与氯沙坦治疗轻中度高血压均有较好疗效,对肾脏具有保护作用。但坎地沙坦控制清晨血压效果更为理想,氯沙坦可显著降低尿酸水平,临床可根据患者病情选用药物。
목적：비교감지사탄여록사탄치료원발성고혈압적림상료효급대신장적보호작용。방법장본원진치적72례경중도원발성고혈압병환자수궤분위감지사탄조여록사탄조,량조분별급여감지사탄구복,8 mg/d,록사탄50 mg/d,료정8주。비교량조치료전후24 h동태혈압개변、심솔진탕초시치( TO)、심솔진탕사솔( TS)급신공능지표적변화。결과감지사탄조여록사탄조치료유효솔분별위84．2%화82．4%,량조비교차이무통계학의의( P>0．05)；감지사탄조치료후24 h 수축압( SBP )급24 h 서장압( DBP )분별위(121．45±10．23)mmHg화(76．24±6．03)mmHg,록사탄조분별위(122．39±10．16)mmHg화(76．53±6．21)mmHg,량조비교차이무통계학의의( P>0．05),단감지사탄조청신혈압 SBP 급 DBP 하강치분별위(13．90±3．32) mmHg 화(9．80±2．17)mmHg,현저우우록사탄조(10．23±2．87)mmHg 화(7．33±2．01)mmHg (P<0．05)；감지사탄조여록사탄조치료후 TO분별위(0．38±0．23)%、(0．40±0．25)%, TS위(5．16±0．83) ms/RRI、(5．09±0．78) ms/RRI,차이무통계학의의(P>0．05)；감지사탄조치료후24 h뇨단백급뇨β2-MG분별위(134．90±19．21)mg화(1．88±0．43)mmol/L,록사탄조분별위(136．73±18．70)mg화(1．87±0．41)mmol/L,량조균현저우우치료전(P<0．05)；량조치료후BUN、SCr여치료전비교차이무통계학의의(P>0．05)；록사탄조치료후뇨산수평현저저우감지사탄조(312．20±18．93)vs (339．84±18．74)μmol/L,P<0．05。결론감지사탄여록사탄치료경중도고혈압균유교호료효,대신장구유보호작용。단감지사탄공제청신혈압효과경위이상,록사탄가현저강저뇨산수평,림상가근거환자병정선용약물。
Objective To compare the effect of candesartan and losartan on essential hypertension patients and the protective effect on renal. Methods 72 patients with mild to moderate hypertension were randomly divided into candesartan group and losartan group. The two group received candesartan 8 mg/d or losartan 50 mg/d for 8 weeks. Ambulatory blood pressure,TO,TS and renal function index were compared between the two groups. Results Effec-tive rate of candesartan group and losartan group were 84. 2% and 82. 4% respectively(P>0. 05). After treatment,24-hour SBP and DBP values of candesartan group were ( 121. 45 ± 10. 23 ) and ( 76. 24 ± 6. 03 ) mmHg, and of which were (122. 39 ± 10. 16) and (76. 53 ± 6. 21) mmHg in losartan group,there were no significant difference of 24-hour SBP and DBP values between the two groups ( P>0. 05 );Decrease value of morning SBP and DBP were ( 13. 90 ± 3. 32) and (9. 80 ± 2. 17) mmHg in candesartan group,and (10. 23 ± 2. 87) and (7. 33 ± 2. 01) mmHg in losartan group(P<0. 05);In candesartan group and losartan group,TO were (0. 38 ± 0. 23)% and (0. 40 ± 0. 25)%,and TS were (5. 16 ± 0. 83) and (5. 09 ± 0. 78) ms/RRI respectively without significant difference between the two groups (P>0. 05);After treatment,24 h urine protein and urineβ2-MG were (134. 90 ± 19. 21)mg and (1. 88 ± 0. 43) mmol/L in candesartan group and (136. 73 ± 18. 70)mg and(1. 87 ± 0. 41)mmol/L in losartan group,of which were superior to pre-treatment in the two groups ( P <0. 05 ) . There were no significant difference of BUN and Scr before and after treatment in the two groups (P>0. 05);After treatment,purine trione in losartan group was much lower than that in candesartan group (312. 20 ± 18. 93) vs (339. 84 ± 18. 74)μmol/L,P<0. 05. Conclusion Candesartan and losartan treatment for mild to moderate hypertension patients both have ideal anti-hypertension effect and protective effect on re-nal function. While candesartan has advantages in controlling morning blood pressure and losartan is better for decrea-sing purine trione. Drugs can be selected according to disease condition in clinical practice.