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目的观察缬沙坦和血管紧张素转换酶抑制剂对老年原发性高血压患者尿白蛋白排泄量(UAER)与内生肌酐清除率(Cr-C)的影响。方法选择120例2~3级的老年原发性高血压患者,分为三组缬沙坦组(n=40)、苯那普利组(n=40)、卡托普利组(n=40),分别进行治疗前、后三组之间降压幅度、UAER、Cr-C的比较。结果缬沙坦治疗老年原发性高血压与苯那普利及卡托普利一样有效。但缬沙坦对UAER[(130±26)mg/24h]、Cr-C[(75±10)ml/min]的影响明显优于苯那普利[(170±28)mg/24h、(63±11)ml/min]及卡托普利[(270±27)mg/24h、(64±13)ml/min],三组比较差异有统计学意义(P<0.01)。缬沙坦组未见干咳现象,而苯那普利组、卡托普利组干咳发生率分别为2.7%、13.7%。结论缬沙坦除有良好的降压作用外,还有更好地降低UAER、提高Cr-C的作用。
Objective To observe the effects of valsartan and angiotensin converting enzyme inhibitors on urinary albumin excretion (UAER) and endogenous creatinine clearance (Cr-C) in elderly patients with essential hypertension. Methods A total of 120 elderly patients with grade 2 to 3 hypertension were divided into three groups: valsartan group (n = 40), benazepril group (n = 40), captopril group (n = 40), respectively, before and after treatment, blood pressure range, UAER, Cr-C comparison between the three groups. Results Valsartan in the treatment of senile essential hypertension was as effective as benazepril and captopril. However, the effect of valsartan on UAER [(130 ± 26) mg / 24h] and Cr-C [75 ± 10] ml / min was significantly better than that of benazepril [(170 ± 28) mg / 63 ± 11) ml / min and captopril [(270 ± 27) mg / 24h and (64 ± 13) ml / min, respectively). There was significant difference between the three groups (P <0.01). There was no dry cough in the valsartan group, while the incidence of dry cough in the benazepril and captopril groups was 2.7% and 13.7%, respectively. Conclusion Valsartan in addition to a good antihypertensive effect, but also to better reduce UAER, improve the role of Cr-C.