CAJ | 학술논문

目的：评价奥美沙坦对轻、中度原发性高血压患者的疗效及心血管病危险因素的影响。方法：采用开放非对照、多中心的方法，本研究入选原发性轻／中度高血压患者150例，按随机数字表法（1∶1）被随机分配到奥美沙坦（口服20～40 mg／d）组或氯沙坦（口服50～100mg／d）组，观察治疗前后收缩压、舒张压、心血管病危险指标高敏C反应蛋白（hsCRP）、尿白蛋白／肌酐、同型半胱氨酸（Hcy）水平及颈动脉内膜中层厚度（IMT）的变化。结果：两组治疗8个月后各指标较治疗前均有明显改善；与氯沙坦组比较，奥美沙坦组收缩压[（145±12） mmHg比（132±9） mmHg]、舒张压[（90±7） mmHg比（80±5） mmHg]下降更显著（P均＜0.01）；hsCRP [（0.54±0.09） mg／L比（0.34±0.09） mg／L]、尿白蛋白／肌酐[（26.5±19.4） mg／g比（23.1±18.3） mg／g]、Hcy [（13.2±4.8）μmol ／L比（10.3±4.2）μmol ／L]水平及IMT [（0.83±0.29） mm比（0.74±0.28） mm]显著下降（P均＜0.05）。结论：对于轻中度高血压患者，奥美沙坦除强效降压外，还能明显降低心血管病危险因素。
목적：평개오미사탄대경、중도원발성고혈압환자적료효급심혈관병위험인소적영향。방법：채용개방비대조、다중심적방법，본연구입선원발성경／중도고혈압환자150례，안수궤수자표법（1∶1）피수궤분배도오미사탄（구복20～40 mg／d）조혹록사탄（구복50～100mg／d）조，관찰치료전후수축압、서장압、심혈관병위험지표고민C반응단백（hsCRP）、뇨백단백／기항、동형반광안산（Hcy）수평급경동맥내막중층후도（IMT）적변화。결과：량조치료8개월후각지표교치료전균유명현개선；여록사탄조비교，오미사탄조수축압[（145±12） mmHg비（132±9） mmHg]、서장압[（90±7） mmHg비（80±5） mmHg]하강경현저（P균＜0.01）；hsCRP [（0.54±0.09） mg／L비（0.34±0.09） mg／L]、뇨백단백／기항[（26.5±19.4） mg／g비（23.1±18.3） mg／g]、Hcy [（13.2±4.8）μmol ／L비（10.3±4.2）μmol ／L]수평급IMT [（0.83±0.29） mm비（0.74±0.28） mm]현저하강（P균＜0.05）。결론：대우경중도고혈압환자，오미사탄제강효강압외，환능명현강저심혈관병위험인소。
Objective:To evaluate therapeutic effect of olmesartan on patients with mild to moderate essential hyper-tension (EH) and its influence on cardiovascular risk factors .Methods:A total of 150 mild/moderate EH patients were enrolled using opened ,non-control and multi-center method .According to random number table ,they were randomly and equally divided into olmesartan group (received olmesartan 20~40 mg/d) and losartan group (re-ceived losartan 50~100 mg/d) .Changes of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) , levels of risk indexes of cardiovascular diseases ,such as high sensitive C reactive protein (hsCRP) ,urinary albumin/creati-nine ,homocysteine (Hcy) and carotid intima-media thickness (IMT) were observed in two groups before and after treatment .Results:After eight-month treatment , compared with before treatment , all indexes significantly im-proved in both groups;compared with losartan group ,there were significant reductions in SBP [ (145 ± 12) mmHg vs .(132 ± 9) mmHg] and DBP [ (90 ± 7) mmHg vs .(80 ± 5) mmHg] , P<0.01 all;and significant reductions in levels of hsCRP [ (0.54 ± 0.09) mg/L vs .(0.34 ± 0.09) mg/L] ,urinary albumin/creatinine [ (26.5 ± 19.4) mg/g vs .(23.1 ± 18.3) mg/g] ,Hcy [ (13.2 ± 4.8)μmol/L vs .(10.3 ± 4.2)μmol/L] and IMT [ (0.83 ± 0.29) mm vs . (0.74 ± 0.28) mm] in olmesartan group , P< 0.05 all .Conclusion:Besides intensively lowering blood pressure olmesartan can also significantly decrease cardiovascular risk factors in patients with mild to moderate hypertension .