硝苯地平和依那普利对高血压患者血压及肾功能影响

Effects of Nifedipine and Enalapril on Blood Pressure and Renal Function in Patients With Essential Hypertention

目的：采用前瞻性、随机对照设计、观察并比较依那普利和硝苯地平控释片对原发性高血压患者的降压效果及对肾功能的影响。方法：４１例 Ⅰ、Ⅱ期原发性高血压患者停用一切降压药 ５天后，进行２４小时无创性动态血压监测和血清肌酐检测，依次随机分为Ａ、Ｂ两组。Ａ组口服硝苯地平控释片３０ｍｇ／ｄ；Ｂ组口服依那普利１０ｍｇ／ｄ。４周后复查动态血压监测及血清肌酐水平，比较治疗前后各项指标的变化。结果：两组患者的２４小时及白昼、夜间平均收缩压（ＳＢＰ），平均舒张压（ＤＢＰ）均有下降，在降压的同时有 ７２． ７％的患者恢复了血压的昼夜节律；内生肌酐清除率（ Ｃｃｒ）有所增加（ Ｐ＜ ０． ０１； Ｐ＜ ０． ０５）。 Ａ组 Ｃｃｒ的改善软 Ｂ组更为明显（ Ｐ＜ ０． ０５）。结论：两种药物对 Ⅰ、 Ⅱ期原发性高血压患者均有良好的降压效果和改善肾功能的作用，对于后一作用尤以硝苯地平控释片更显著。

objective:To investigate the effects of Nifedipine and Enalapril conrtolled-ralease tablets on blood pressure and renal function in patients with essential hypertention(Ⅰ、Ⅱ stage). Methods: Changes of 24-hour ambulatory blood pressure(ABP) and serum ~creatinine(Scr) 、cratinine clearance(Ccr) were observed in 41 cases. Patients were randomly divided into two groups. Nifedipine (30mg/d) and Enalapril (10mg/d) controlled-release tablets were administered to A and B groups for 4 weeks respectively. Differences of ABP and Scr.Ccr before and after treatment were compared between two groups. Results: Systolic blood pressure and diastolic blood pressure of 24 hour were significantly decreased (P < 0.01 ). 72. 2% of the patients recovered their day and night rhythm of ABP. Ccr was improved in A and B groups(P <0.01; P <0.05). In comparison with B group, improvement of Ccr in A group significant. Conclusion: Both medicines show a good effect on controlling blood pressure. Nifedipine slow-release tablet is better than Enalapril in protecting renal function of patients with essential hypertension(Ⅰ、Ⅱ stage).