两种钙离子拮抗剂对 ESWL 时保护肾功能的初探

Protection of renal function from damage due to ESWL by calcium channel blockers

为了避免和减小ＥＳＷＬ对肾功能的损伤，应用两种钙离子拮抗剂（络活喜、硝苯地平）进行研究对照。６０例肾盂及输尿管上段结石进行ＥＳＷＬ治疗，随机分为络活喜组，硝苯地平组和对照组，各２０例。ＥＳＷＬ前３天分别口服络活喜，硝苯地平；对照组不服用任何药物。采用放射免疫法测定ＥＳＷＬ前后２４小时尿α微球蛋白（α１ＭＧ）、β２－微球蛋白（β２ＭＧ）、白蛋白（Ａｌｂ）、ＴＨ糖蛋白（ＴＨＰ）及尿免疫球蛋白（ＩｇＧ）的变化。ＥＳＷＬ后对照组尿α１ＭＧ、β２ＭＧ、Ａｌｂ及ＩｇＧ分泌量明显高于ＥＳＷＬ前水平（Ｐ＜０００１）；尿ＴＨＰ明显低于ＥＳＷＬ前水平（Ｐ＜０００１）。络活喜组尿Ａｌｂ、ＩｇＧ比ＥＳＷＬ前增加（Ｐ＜００１，Ｐ＜００５）。硝苯地平组仅尿Ａｌｂ比ＥＳＷＬ前增加（Ｐ＜００５）。认为两种钙离子拮抗剂对ＥＳＷＬ时肾功能损害均有保护作用，硝苯地平的疗效优于络活喜。

Norvasc and nifedipine,2 calcium antagonists,were used in 60 cases of renal or upper ureteral stone to protect the renal function from damage due to ESWL.The patients were randomly divided into 3 groups,the norvasc group,the nifedipine group and the control group.Norvasc and nifedipine was given to the first 2 groups respectively for 3 days before ESWL but nothing to the control group.α 1 MG、β 2 MG、Alb,TH P and IgG in 24 hours urine both before and after ESWL were measured by radio immunological assay (RIA).In the controls,a significant increase of urinary α 1 MG、β 2 MG、Alb and IgG ( P <0.001) and a decrease of TH P ( P <0.001)were noted.In the norvasc group,urinary Alb ( P <0.01) and IgG ( P <0.05) was increased. after ESWL while in the nifedipine group only Alb ( P <0.05) was increased. It was concluded that both norvasc and nifedipine would protect the renal function form damage due to ESWL and nifedipine is superior to norvasc.