目的　探讨氯沙坦 (losartan ,LOS)对高血压病 (EH)患者的血尿酸 (UA)及血、尿 β2 -微球蛋白 (β2 -MG)的作用 ,并与培哚普利 (perindopril,PER)进行比较。方法　对 118例经停用降压药 2周的轻中度EH患者采取随机单盲自身前后对照 ,分为氯沙坦组 (LOS组 ,n =5 9)和培哚普利组 (PER组 ,n =5 9) ,分别服用LOS(美国默沙东公司产品 ,5 0～ 10 0mg/d)和PER(法国施维雅公司产品 ,4～ 8mg/d) ,4周为 1疗程。于治疗前、治疗后 2周及 4周分别测诊室坐位血压 (SiBP)。于治疗前及 4周疗程结束时分别查血尿酸 (UA)、血尿 β2 -MG、血胆固醇 (Ch)、高密度脂蛋白胆固醇 (HDL -C)、低密度脂蛋白胆固醇 (LDL -C)、甘油三脂 (TG)、血尿素氮(BUN)及血肌酐 (Cr)。观察期间均避免使用降尿酸药物、利尿剂、降脂药及其他影响尿酸的药物。结果　结果显示两种药物能同等程度有效降低EH患者的动脉血压及血、尿 β2 -MG。此外氯沙坦还有效降低血UA ,而对血Ch、TG、BUN及Cr无影响。结论　氯沙坦既有效降低血、尿 β2 -MG ,又有效降低血UA ,而培哚普利只有效降低血及尿 β2 -MG ,提示LOS即能改善肾功能 ,又能改善代谢紊乱。 Objective To investigate the effects of losartan (LOS) on blood uric acid (UA) and blood and urine β2 - microglobulin (β2 - MG) in patients with essential hypertension (EH) PER) for comparison. Methods One hundred and fourteen patients with mild to moderate EH who underwent antihypertensive drugs for two weeks were randomly divided into losartan group (LOS group, n = 59) and perindopril group (PER group) , n = 5 9). LOS (50 ~ 100 mg / d) and PER (4 ~ 8 mg / d) were administered to LOS for 4 weeks for 1 course of treatment respectively. Before treatment, 2 weeks and 4 weeks after treatment were measured sitting blood pressure (SiBP). UA, hematuria β2 -MG, Ch, HDL-C, LDL-C were measured before treatment and at the end of the 4-week treatment period. Triglyceride (TG), blood urea nitrogen (BUN) and serum creatinine (Cr). During the observation period to avoid the use of uric acid drugs, diuretics, lipid-lowering drugs and other drugs that affect uric acid. The results showed that the two drugs can effectively reduce the EH in patients with arterial blood pressure and blood, urine β2-MG. Losartan also effectively reduce blood UA, but no effect on blood Ch, TG, BUN and Cr. Conclusions Losartan can effectively reduce blood and urine β2 -MG and blood UA, while perindopril can only reduce blood and urine β2 -MG, suggesting that LOS can improve renal function and improve metabolic disorders.