氯沙坦对早期慢性肾衰竭患者蛋白尿和肾功能的影响

目的：观察氯沙坦对早期慢性肾衰竭(CRF)患血压、蛋白尿和肾功能的可能有利效应。方法：早期CRF病人(Scr135～442μtool／L或Ccr30～50ml／min)56例，其中慢性肾小球肾炎31例，2型糖尿病肾病15例，高血压肾小动脉硬化症10例。随机分为两组，氯沙坦组(N=30)给予氯沙坦50mg每日1次；对照组(N=26)给予洛汀新10mg每日1次，共4个月。观察血压、尿蛋白、BUN、Scr和Cer、等指标。结果：氯沙坦与洛汀新一样均能有效降低血压、减少尿蛋白、降低BUN和Scr、增加肾小球滤过率。其对轻中度慢性肾衰竭的患疗效较好，治疗期间未见严重毒副作用和过敏反应。结论：氯沙坦具有良好的降血压、减少蛋白尿作用，能延缓早期CRF患肾功能的进展，其副作用少，病人耐受性好。但有关氯沙坦对中重度高血压、大量蛋白尿及CRF晚期患的疗效尚需大样本的长期研究来证实。

Effect of Losartan on proteinuria and renal function of eaily chronic renal failure

Objective: To investigate the effect of angiotensin n receptor antagonist (AURA) Losartan onblood pressure ,proteinuria and renal funtion in patients with mild or moderate chronic renal failure (CRF) .Methods: In four - month trial involving 56 patients with mild ormoderate CRF caused by various disorders(Scr 135-442uuuuuuumol/ L or Ccr30-50ml/min),52 patients finished the trial. The underlying diseases included chronic glomerulonephritis(in 31 patients), diabetic nephropathy (in 15 patients)and hypertension nephrosclerosis(in 10 patients) .All patients were randomly divided into two groups: Losartan group and control group(lotensin group) .Patients in Losartan group(n = 30) received Losartan 50mg everyday, patients in lontensin group (n = 26) received lotensin 10mg everyday.Blood pressure,urinary protein, serum cretinine, BUN and Creatinine clearance rate (Ccr) were detected before and after therapy. Results: At four months, patients in Losartan group and lontensin group both had lower systolic and diastolic blood pressure, fewer urinary protein excretion, lower Scr and BUN, higher Ccr. The effect of Losartan was as good as the effect of lotensin, we had not found serious side -effect of Losartan during the ttial. Conclusion: Losartan can significantly reduce blood pressure and urinary protein, and slow the progression of mild or moderate CRF in patients with various renal diseases.