肾性高血压患者血压波动规律与降压药物的选择

Fluctuition trend of renal parenchyma hypertention and selection of anti-hypertensive agents

应用24h动态血压监测仪（TM－2420，日本）观察40例肾性高血压患者昼夜血压变化规律、苯那普利联合苯碘酸氨氯地平治疗后血压变化及其降压谷：峰比值。结果发现肾性高血压患者丧失了正常人体血压波动规律，夜间血压与白昼血压相比无显著性差异（P＜0．01），治疗后无论是24h平均血压、白昼血压与夜间血压以及24h血压负荷值均较治疗前显著下降（P＜0．01）。联合用药降压谷：峰比值为收缩压（72．6±11．3）％，舒张压（64．1±9．6）％。治疗过程中发现咳嗽及头痛各2例，轻度腹泻1例。提示：①肾性高血压患者无论是白昼还是夜间大部分时间处于高血压对靶器官的损害状态；②联合应用盐酸苯那普利和苯磺酸氨氯地平可有效地控制患者24h血压水平，降低患者靶器官损害的危险性。

The changing trend of blood pressure in 40 patients with primary renal diseases in 24 hours and the anti-hypertensive effect of benazepril HCl plussing amoldipine were observed by using ambulatory blood pressure monitoring. The results showed that: ①These patients lost the normal blood pressure fluctuation regularity. ②After treatment the mean 24-hour blood pressure, the mean daytime blood pressure,the mean nighttime blood pressure and the mean loading value significantly dropped,compared with that before treatment (P<0. 01 ). These findings suggested that:①The hypertensive patients with primary renal diseases were under a situation in which the end-organs were damaged by hypertension at daytime and nighttime. ②Taking benazepril HCl plussing amoldipine could effectivelly control the hypertension and protect the end-organs in mostof the patients.