摘要
目的 观察氯沙坦 (科素亚 )对老年高血压患者肾脏血流动力学及肾功能的影响。方法 选择 43例老年高血压患者 ,给予氯沙坦 50～ 1 0 0 mg/日 ,治疗 1 2～ 1 7个月 ,应用彩色多普勒超声 ,分别测定治疗前后肾血流动力学及肾结构的变化 ,检测血浆血管紧张素 (Ang- ) ,血、尿 β2微球蛋白 (β2 - MG)水平。结果 氯沙坦治疗后患者血压明显下降 (P<0 .0 0 1 ) ,肾血流阻力指数 (RI)、搏动指数 (PI)、Vsmax/ Vdmin比值双肾均显著降低 (P<0 .0 1 ) ,治疗后管壁厚度明显变薄 ,治疗前后肾动脉管壁厚度有显著差异 (P<0 .0 1 ) ,动脉内径增宽 (P<0 .0 5)。血 β2 - MG浓度降低、尿 β2 -MG排泄量明显减少 (P<0 .0 1 ) ,血浆 Ang- 水平有增加趋势 (P>0 .0 5)。结论 氯沙坦有降血压、降低肾动脉血管阻力 ,增加肾血流量 ,改善肾血管结构 ,降低血β2 - MG,降低尿β2 - MG排泻 ,从而改善肾脏功能。
Objective To observe the clinical effect of Losartan on renal hemodynamics and function in elderly hypertensive patients.Methods Forty-three elderly hypertensive patients were treated with Losartan, 50-100 mg/d for twelve to seventeen months. The variation of renal hemodynamics and structure, plasma AngⅡ, blood and urine microglobulin of β 2-MG before and after treatment,applying the colour Doppler Ultrasonography and kits,were determined.Results After treatment the pationts' blood pressure have reduced effectively (P<0.001). RI,PI and the Vsmax/Vdmin ratio were markedly decreased in left (P<0.01) and right (P<0.05)kidney after treatment. Thickness of renal arterial wall was significantly decreased (P<0.01), the renal arterial diameter were obviously increased (P<0.05), β 2-MG in blood and urine were obviously decreased after administration. The level of plasma AngⅡ has a slightly increased trend(P>0.05).Conclusions Losartan was effective in reducing hypertension, it also could decrease the renal arterial vessel resistance and increase the renal blood flow and improve the renal vessel structure, decrease the concentration of β 2-MG in blood and urine,and then improved renal function.
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2003年第11期720-721,共2页
Chinese Journal of Gerontology
