双倍剂量氯沙坦治疗IgA肾病中蛋白尿疗效评价

目的：探讨双倍剂量氯沙坦氯沙坦在IgA肾病（IgA nephropathy，teAN）中降低蛋白尿的临床疗效。方法：选取40例经肾穿刺病理诊断为IgAN的患者，随机分为2组，A组18例采用单剂量（50mg，qd）氯沙坦；B组22例用双倍剂量（100mg，qd）氯沙坦，观察8周后两组的血压、实验室指标：血肌酐、尿素氮、血钾、24h尿蛋白、内生肌酐清除率（creatinine clearancerate，CCr）等以及临床症状，并作安全性评价。结果：B组患者24h蛋白尿下降（0．91±0．33g／24h），A组患者蛋白尿下降（0．21±0．22g／24h），B组24h蛋白尿下降率明显高于A组（P〈0．05）。双倍剂量氯沙坦在IgAN治疗中未出现不良反应，包括高血钾、咳嗽、低血压或水肿等。结论：双倍剂量氯沙坦在治疗IgAN中降蛋白尿的疗效较单剂量明显，应用安全，耐受性好，无明显不良反应。

Therapeutic Evaluation of Double-Dose Losartan on Albuminuria in Patients with IgA Nephropathy

Objective： To explore the clinical efficacy of double-dose losartan on albuminuria in patients with IgA nephropathy （I- gAN）. Methods： 40 patients diagosed with IgAN acorrding to renal biopsy were selected and randomly divided into 2 groups, A group （n=18, 50 mg losartan daily） and B group （n=22, double-dose of 100 mg losartan daily）. The blood pressure, laboratory index, including blood creatinine, urea nitrogen, blood potassium, 24 h urine protein, creatinine clearance rate （CCr） etc., as well as clinical symptom and the evaluation ofsafly were compared between the two groups. Results： 24 h urine protein in B group was decreased to （0.91 ± 0.33g/24h） and was decreased to 0.21± 0.22 g/24 h in A group. The decrease rate of 24 h urine protein in B group was significantly higher than that in A group （P〈0.05）. No side effect was found in double-dose losartan treatment on IgAN, including high blood potassium, cough, low blood pressure or edema. Conclusion： Double-dose losartan treatment is more effecive than single-dose treatment, safe, well tolerated and has no obvious side effect.