地尔硫■缓释片对血压和肾功能的作用

Antihypertensive and Renal Effects of Slow Release Tablet of Diltiazem in Hypertensive Patients with Different Degrees of Renal Function

20例高血压患者按内生肌酐清除率（CLcr）、尿素氮（BUN）和肌酐（Cr）水平分为肾功能正常和受损两组，每组10例。均服地水硫■缓释片90mg，2／d，共7d。观察治疗前后血压、心率和肾功能变化，并用自动血压监测仪测量服药第7d的24h血压。结果：（1）该药能降低两组病人的收缩压和舒张压（P＜0．01），降压作用维持24h。（2）在肾功能受损组，该药能增加CLcr，ERPF，降低UMAE，BUN和Cr（P＜0．01）。因此地尔硫■缓释片不仅能有效地降低血压，而且能改善肾功能，适合高血压伴肾功能不全患者的治疗。缓释剂型能减少服药次数和减轻不良反应，提高降压治疗的顺应性。

Twenty hypertensive patients were divided into two groups in normal renal function group (10 patients ) and renal function impairment group (10 patients ) according to the creatinine clearance (CLcr), blood urea nitrogen (BUN ) and creatinine (Cr) levels. The patients were studied to assess the short-term (7 days) effects of slow release tablet of diltiazem monotherapy (90 mg,given twice daily) on blood pressure and renal function. Change in blood pressure was observed once daily and also recorded by an automatic blood pressure monitor over 24 hours on the 7th day. Renal function parameters included CLcr,effective renal plasma flow (ERPF), urinary microalbumin excretion (UMAE), serum and urinary β2 microglobumin (β2-MG),BUN and Cr. Results: (1)Antihypertensive efficacy of diltiazem in patients with normal renal function (NRF) was similar t that in patients with impaired renal function (IRF) and the hypotensive action lasted over 24hours, (2)CLcr and ERPF were improved, UMAE, BUN and Cr were decreased in the patients with IRF, It can therefore be concluded that slow release tablet of diltiazem may not only control arterial pressure, but also exert a renal protective ef fect.Diltiazem may be effective for hypertensive patients with IRF. A prolonged lowering effect on blood pressure would be expected with the twice daily of slow release tablet of diltiazem.