福辛普利与硝苯吡啶治疗高血压病对患者肾功能的影响

To Investigate the Effects on Patient′s Renal Function by Treatment of Hypertension with Fosinopril and Nifedipin

目的 探讨福辛普利、硝苯吡啶单独和联合应用对高血压肾功能的影响。方法 96例高血压病患者随机分为 2组 ,福辛普利组 (10～ 2 0mgqd 2 3例 ) :硝苯吡啶组 (10mgTid 39例 )。治疗 2周后未达目标血压 (<140 90mmHg)者 ,归入联合治疗组 (单药剂量同前 2组 34例 ,有 6例血压仍不能达标 ,剔除观察 ,实际 2 8例 )。疗程 12个月 ,记录治疗前后肾功能指标变化及治疗后各组平均血压。结果 (1)治疗后 3组平均血压对比无统计学差异。(2 )治疗后福辛普利和联合治疗组血肌酐和血、尿 β2 -MG均有明显下降 (P<0 .0 1) ;肌酐清除率明显增加 (P<0 .0 1)。 (3)硝苯吡啶组治疗后血肌酐和血、尿β2 -MG虽有所下降 ,肌酐清除率有所增加 ,但未达统计学水平。 结论 福辛普利长期单用或与硝苯吡啶合用 ,在降压同时能有效地降低血肌酐和血、尿 β2 -MG ,增加肌酐清除率 。

Objective:To investigate the treatment of hypertension by single drug fosinopril or nifedipin or by combination of two drugs and their effects on patient′s renal function.Methods:96 consecutive patients with hypertension were randomly divided into 2 groups i.e.fosinopril group,received 10-20mg each day(F group,n=23) and nifedipin group,received 10mg 3 times a day(N group,n=39).After 2 weeks of treatment,34 patients couldn′t reach the normal blood pressure(B.P.<140/90mmHg),then were entered into the combined drug group.received same dosage of each drug as in single drug group.Among them,6 patients were refractory to combined drug treatment,so in fact,28 patients entered into FN group(n=28).The total treatment course was 12 months.The renal functional criteria before and after treatment and the mean B.P.level after teratment in each group were recorded.Results:1.There was no statistical significant difference about mean B.P.in 3 groups after treatment.2.In F and FN groups after treatment,the blood creatinine,blood and urine β2-MG were significantly reduced(P<0.01) and creatinine clearance rate was significantly increased(P<0.01).3.In N group after treatment,the blood creatinine and blood and urine β2-MG were reduced and creatinine clearance rate was increased but without statistical significance.Conclusion:Fosinopril or fosinopril in combination with nifedipin is effective in treatment of hypertension and at the same time can effectively protect the patient′s renal function.