Franscini Lorenzo M D, Von Vigier Rodo O, Pfister Roger, Casaulta-Aebischer Carmen, Fossali Emilio, Bianchetti Mario G
Division of Nephrology, University Children's Hospital, Inselspital, Berne, Switzerland.
Am J Hypertens. 2002 Dec;15(12):1057-63. doi: 10.1016/s0895-7061(02)03083-2.
Studies in adults with chronic kidney diseases demonstrate that the orally available angiotensin II antagonist irbesartan reduces arterial pressure and pathological proteinuria, mostly with an excellent tolerability profile. Little information is available on irbesartan in childhood.
A total of 44 pediatric outpatients with chronic kidney disease (27 male and 17, aged 3.7 to 18 years, median 10 years) were given irbesartan once a day during 18 weeks for arterial hypertension (N = 23), proteinuria (N = 8), or both (N = 13).
In patients with hypertension, the use of irbesartan 4.1 (3.1-5.3) mg/kg body weight daily (median and interquartile range) was associated with a decrease (P <.005) in arterial pressure by 17 (13-22)/10 (7-12) mm Hg. In patients with overt proteinuria the urinary protein excretion decreased (P <.01) during treatment with irbesartan (2.9 [2.0-4.8] mg/kg body weight) by 52 (0-75) mg/[m(2) x h]), whereas plasma albumin increased (P <.05) by 4 (1-5) g/L. The frequency of abdominal pain, constipation, cough, diarrhea, dizziness, edema, fatigue, headache, insomnia, myalgia, orthostasis, and rash was similar before and with irbesartan. Plasma sodium slightly decreased, whereas plasma potassium increased, with irbesartan (P <.01).
In pediatric patients with chronic kidney diseases, irbesartan given once a day for 18 weeks significantly reduces arterial pressure and proteinuria, with an excellent tolerability and side effect profile.
针对成年慢性肾脏病患者的研究表明，口服有效的血管紧张素II拮抗剂厄贝沙坦可降低动脉血压并减少病理性蛋白尿，且大多具有良好的耐受性。关于厄贝沙坦在儿童中的应用信息较少。
共有44例慢性肾脏病儿科门诊患者（27例男性，17例女性，年龄3.7至18岁，中位数10岁），因动脉高血压（N = 23）、蛋白尿（N = 8）或两者兼有（N = 13），接受为期18周的每日一次厄贝沙坦治疗。
在高血压患者中，每日使用4.1（3.1 - 5.3）mg/kg体重的厄贝沙坦（中位数和四分位间距）可使动脉血压降低（P <.005）17（13 - 22）/10（7 - 12）mmHg。在明显蛋白尿患者中，使用厄贝沙坦（2.9 [2.0 - 4.8] mg/kg体重）治疗期间，尿蛋白排泄量减少（P <.01）52（0 - 75）mg/[m²×h]，而血浆白蛋白增加（P <.05）4（1 - 5）g/L。腹痛、便秘、咳嗽、腹泻、头晕、水肿、疲劳、头痛、失眠、肌痛、直立性低血压和皮疹的发生频率在使用厄贝沙坦前后相似。使用厄贝沙坦后，血浆钠略有下降，而血浆钾升高（P <.01）。
在患有慢性肾脏病的儿科患者中，每日一次给予厄贝沙坦治疗18周可显著降低动脉血压和蛋白尿，耐受性良好且副作用较少。
