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不同剂量氯沙坦对高血压病并发Ⅱ型糖尿病患者微量白蛋白尿及血管内皮功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2008年第1期
页码:
45-48
栏目:
临床研究
出版日期:
2008-01-20

文章信息/Info

Title:
Effects of losartan at different doses on microalbuminuria and endothelial functions in patients with essential hypertension and type two diabetes mellitus
作者:
丁茹; 任雨笙; 樊民; 黄佐
第二军医大学附属长征医院心内科，上海 200003
Author(s):
DING Ru;  REN Yusheng;  FAN Min;  HUANG Zuo
Department of Cardiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
关键词:
氯沙坦; 高血压; 糖尿病; 蛋白尿; 血管内皮功能
Keywords:
losartan;  hypertension;  diabetes mellitus;  microalbuminuria;  endothelial function
分类号:
R972
DOI:
-
文献标识码:
A
摘要:
目的 探讨不同剂量氯沙坦对高血压病并发Ⅱ型糖尿病患者微量白蛋白尿及血管内皮功能的影响。方法 将31例伴有持续微量白蛋白尿的高血压病并发Ⅱ型糖尿病患者随机分为2组，分别接受氯沙坦50 mg/d（A组，16例）及100 mg/d（B组，15例）口服治疗16周，检测并比较两组患者治疗前后尿白蛋白排泄率（UAER）、肱动脉血流介导的血管舒张反应（FMD）。结果 A、B两组患者经氯沙坦治疗16周后平均UAER水平分别由（114±31）μg/min、（108±30）μg/min降至（92±26）μg/min、（74±28）μg/min（均P<0.01），B组降低程度更为显著（P<0.05）；A、B两组患者治疗后平均FMD内径变化率分别由治疗前（6.5±1.9）%、（6.8±1.0）% 增至（7.0±1.2）%、（7.2±1.1）%（均P<0.01），B组的增加程度更为显著（P<0.05）。UAER与FMD内径变化率呈负向线性关系（r=-0.78，P<0.05）。结论 与每日使用50 mg氯沙坦相比，每日使用100 mg氯沙坦可以更为显著地降低这类患者尿微量白蛋白的排泄，更为有效地改善其血管内皮功能，并且具有良好的安全性及耐受性。
Abstract:
AIM To explore the effects of losartan at different doses on microalbuminuria and endothelial functions in patients with essential hypertension (EH) and type two diabetes mellitus (DM). METHODS Totally 31 hypertensive and diabetic patients with microalbuminuria were randomly divided into two groups and were treated respectively with losartan 50 mg once daily (group A, n=16) or 100 mg once daily (group B, n=15) for 16 weeks. Urinary albumin excretion rate (UAER) and brachial artery flowmediated dilation (FMD) were measured and compared. RESULTS After treatment, UAER decreased significantly in both group A ［(114±31)μg/min vs (92±26)μg/min, P<0.01］ and group B ［(108±30)μg/min vs (74±28)μg/min, P<0.01］ but the decrease in group B was more significant than that in group A (P<0.05). FMD of patients in both groups significantly improved after treatment, from (6.5±1.2)% to (7.0±1.2)% in group A (P<0.01) and from (6.8±1.0)% to ( 7.2±1.1)% in group B (P<0.01). A significant negative relationship was found between FMD and UAER (r=-0.78, P<0.05). CONCLUSION The level of microalbuminuria can reflect the severity of endothelial functions in patients with EH and DM. Losartan at the dosage of 100 mg/day, safe and tolerable, better improves the endothelial dysfunction and microalbuminuria than the dosage of 50 mg/day.

参考文献/References

［1］ Hillege HL, Fidler V, Diercks GF，et al. Urinary Albu min Excretion Predicts Cardiovascular and Noncardiovascular Mortality in General Population［J］. Circulation，2002，106(14)：1777-1782.

［2］ Brenner BM,Cooper ME,de Zeeuw D，et al. Effects of losartan on renal and cardiovascular outcomes in patients witn type 2 diabetes and nephropathy［J］. N Engl J Med，2001，345(12)：861-869.

［3］ Schiffrin EL，Park JB，Intengan HD，et al. Correction of arterial structure and endothelial dysfunction in human essential hypertension by the angiotensin receptor antagonist losartan［J］. Circulation，2000，101(14):1653-1659.

［4］ 王晓瑛，俞锋.氯沙坦对高血压并发肾功能损害及左室肥厚的影响［J］.心脏杂志，2004，16(3)：291-292.

［5］ Mattock MB，Morrish NJ，Viberti G，et al.Prospective study of microalbu minuria as predictor of mortality in N1DDM［J］．Diabetes，1992，41(6)：736-741.

［6］ Segura J，Ruilope LM，Rodicio JL．Microalbuminuria［J］. Clin Exp Hypertens，2004，26(78)：701-707.

［7］ Rachmani R，Levi Z，Lidar M，et al. Considerations about the threshold value of microalbu minuria in patients with diabetes mellitus: lessons from an 8year followup study of 599 patients［J］. Diabetes Res Clin Pract，2000，49(23)：187-194.

［8］ Valmadrid CT，Klein R，Moss SE，et al.The risk of cardiovascular disease mortality associated with microalbu minuria and gross proteinuria in persons with olderonset diabetes mellitus［J］. Arch Intern Med，2000，160(8)：1093-1100.

［9］ Deckert T.Nephropathy and coronary death:the fatal twins in diabetes mellitus［J］. Nephrol Dial Transplant，1994，9(8)：1069-1071.

［10］林金秀，吴可贵，蔡洪斌，等. 氯沙坦对高血压病人24小时血压的影响［J］. 高血压杂志，2001，9（1）：24-26.

［11］Zandbegen AA,Baggen MG,Lamberts SW,et al. Effect of losartan on microalbuminuria in normotensive patients with type 2 diabetes mellitus. A randomized clinical trial［J］. Ann Intern Med,2003,139(2):90-96.

［12］Chan JC,Wat NM,So WY，et al. Renin angiotensin aldosterone system blockade and renal disease in patients with type 2 diabetes.An Asian perspective from the RENAAL study［J］.Diabetes Care, 2004，27(4)：874-879.

［13］于力，裴兆辉.血管紧张素Ⅱ受体拮抗剂在心血管疾病中的I临床应用［J］.心脏杂志，2002，14(3)：266-267.

备注/Memo

备注/Memo:
收稿日期：2007-02-05.基金项目：上海市自然科学基金项目资助（03ZR14029）通讯作者：任雨笙,副主任医师,主要从事冠心病基础及临床研究Email：renyusheng@gmail.com 作者简介：丁茹,主治医师,硕士Email：drdrl@163.com
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