Kurokawa Kiyoshi, Abe Keishi, Saruta Takao, Arakawa Masaaki, Kikkawa Ryuichi, Ueda Naohiko, Onoyama Kaoru, Tomita Kimio, Ogawa Nobuya
Department of Internal Medicine VII, School of Medicine, Tokai University, Isehara, Japan.
J Renin Angiotensin Aldosterone Syst. 2002 Sep;3(3):167-75. doi: 10.3317/jraas.2002.037.
A prospective, randomised, double-blind, parallel-group, dose-response trial was conducted to investigate the antiproteinuric effect of candesartan cilexetil, the angiotensin II type 1 receptor blocker, in patients with chronic glomerulonephritis. Patients (n=280) were treated for 12 weeks with candesartan cilexetil 2, 4, or 8 mg given orally once-daily (o.d.). The improvement in urinary protein excretion observed at the end of the treatment period was 15.9% in the 2 mg group, 25.6% in the 4 mg group, and 34.6% in the 8 mg group, respectively, showing a clear dose-response (2 mg <4 mg <8 mg; p=0.003). The mean reduction in urinary protein excretion was 11.3% in the 2 mg group, 26.3% in the 4 mg group, and 26.0% in the 8 mg group, showing a dose-response pattern, in that the effect of 4 mg and 8 mg was greater than that of 2 mg (2 mg <4 mg asymptotically equal to 8 mg; p=0.010). As the observed reduction in urinary protein excretion failed to correlate with changes in mean blood pressure, it could not be attributed to the antihypertensive effect of the study drug alone. This suggests that candesartan cilexetil, 4 8 mg o.d., has antiproteinuric effects in patients with chronic glomerulonephritis.
开展了一项前瞻性、随机、双盲、平行组、剂量反应试验，以研究1型血管紧张素II受体阻滞剂坎地沙坦酯对慢性肾小球肾炎患者的抗蛋白尿作用。患者（n = 280）接受坎地沙坦酯2、4或8 mg口服，每日一次，治疗12周。治疗期结束时观察到的尿蛋白排泄改善情况，2 mg组为15.9%，4 mg组为25.6%，8 mg组为34.6%，呈现明显的剂量反应关系（2 mg < 4 mg < 8 mg；p = 0.003）。2 mg组尿蛋白排泄平均降低11.3%，4 mg组为26.3%，8 mg组为26.0%，呈现剂量反应模式，即4 mg和8 mg的效果大于2 mg（2 mg < 4 mg渐近等于8 mg；p = 0.010）。由于观察到的尿蛋白排泄降低与平均血压变化无关，因此不能仅归因于研究药物的降压作用。这表明，每日口服4至8 mg坎地沙坦酯对慢性肾小球肾炎患者有抗蛋白尿作用。
