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目的 :比较氯沙坦与贝那普利对慢性肾小球肾炎高血压、蛋白尿、肾功能的影响。方法 :6 6例慢性肾小球肾炎病人分成 2组。氯沙坦组 34例 (男性 19例 ,女性 15例 ,年龄 4 0a±s 13a)。贝那普利组 32例 (男性 14例 ,女性 18例 ,年龄 38a± 15a)。在原用降脂药、抗凝药的基础上 ,氯沙坦组加氯沙坦5 0mg ,po ,qd ,贝那普利组加贝那普利 10mg ,po ,qd。治疗 4wk舒张压≥ 11.3kPa病人加氢氯噻嗪12 .5～ 2 5mg ,po ,qd ,总疗程为 2 4wk。结果 :2组治疗 2 4wk后 ,血压达目标值的病人分别为 4 7%和5 0 % (P >0 .0 5 ) ,蛋白尿下降分别为 1.9g·2 4h- 1± 1.1g·2 4h- 1和 1.7g·2 4h- 1± 1.3g·2 4h- 1(均P <0 .0 1) ,血肌酐保持稳定。氯沙坦组咳嗽等不良反应发生率 6 % ,贝那普利组发生率 2 6 %。结论 :氯沙坦具有类似贝那普利降低蛋白尿、肾功能保护作用 ,且具有不良反应少的优点。
Objective: To compare the effects of losartan and benazepril on hypertension, proteinuria and renal function in patients with chronic glomerulonephritis. Methods: Sixty-six patients with chronic glomerulonephritis were divided into two groups. Losartan group 34 patients (19 males and 15 females, age 40a ± s 13a). The benazepril group of 32 patients (14 males and 18 females, age 38a ± 15a). In the original lipid-lowering drugs, based on anticoagulants, losartan group plus losartan 50mg, po, qd, benazepril group plus benazepril 10mg, po, qd. Treatment 4wk diastolic blood pressure ≥ 11.3kPa patients hydrochlorothiazide 12.5 ~ 25mg, po, qd, the total course of 24wk. Results: After 24 weeks of treatment, the blood pressure reached the target value of 47% and 50% respectively (P> 0.05), and the proteinuria dropped 1.9g · 2 4h-1 ± 1.1g · 2 4h-1 and 1.7g · 2 4h- 1 ± 1.3g · 2 4h-1 (all P <0.01), serum creatinine remained stable. Losartan group cough and other adverse reactions occurred in 6%, benazepril group incidence of 26%. CONCLUSION: Losartan has a similar effect of benazepril in reducing proteinuria and renal function, with fewer side effects.