硝苯地平控释片和雷米普利降血压作用及对肾功能的影响

The effect of nifedipine and ramipril of lowering blood pressure and the impact on renal function

目的观察并比较硝苯地平控释片和雷米普利对慢性肾脏病（CKD）患者的降压效果以及对肾功能的影响。方法将46例CKD患者随机分为两组，雷米普利（2．5mg／d）组与硝苯地平（30mg／d）组，每组23例，连续使用8周，比较两组治疗前后24h平均收缩压（SBP）和平均舒张压（DBP），昼、夜间SBP和DBP，24h尿蛋白定量及肾功能的变化。结果两组患者的SBP和DBP均有所下降。降压的同时，雷米普利组82％的患者、硝苯地平组78％的患者恢复了血压的昼夜节律，血肌酐、尿蛋白有所下降。雷米普利组24h尿蛋白定量减少幅度明显高于硝苯地平组。结论硝苯地平和雷米普利对CKD患者均有良好的降压效果和改善肾功能的作用，雷米普利降低尿蛋白的疗效明显强于硝苯地平。

Objective To investigate and compare the effect of nifedipine and ramipril of lower ing blood pressure of patients with chronic kidney disease（CKD） and the impact on renal function. Methods Forty-six patients with CKD were equally and randomly divided into two groups,receiving 2. 5 mg ramipril and 30 mg nifedipine once daily for 8 weeks. Changes of 24 h systolic blood pressure （SBP） and diastolic blood pressure（DBP）, day SBP and DBP, night SBP and DBP, the renal function and urine protein were detected before and after the treatment. Results Twenty-four systolic blood pressure and diastolic blood pressure were significantly decreased in both two groups. 82% of the patients in rmnipril group and 78% of the patients in nifedipine group recovered their day and night rhythm of blood pressure. The blood creatinine and urine pratein were decreased signifieantly. In ranlipril group, the excretion of urine protein was significantly lower than that in the nifedipine group. Conclusions Nifedipine and ramipril can significantly lower blood pressure and protect renal function of the patient with CKD, and the efficacy of ramipril reducing urine protein level was more significant than nifedipine.