拉西地平和福辛普利对高血压肾脏保护作用的对比研究  

Comparison of the protective effect of lacidipine and fosinopril on kidney in hypertensive patients

作　　者：闫立敏[1] 李冬梅[1] 李丹[1] 吴艳英[1] 杨柏新[1] 

机构地区：[1]武警吉林省总队医院内二科,吉林省长春市130052

出　　处：《实用老年医学》2008年第5期376-378,共3页Practical Geriatrics

摘　　要：目的观察拉西地平和福辛普利对高血压病人肾功能及肾动脉结构的影响，比较拉西地平和福辛普利对高血压病人肾脏的保护作用。方法选择106例高血压2—3级患者，随机分为拉西地平组和福辛普利组，治疗前后检测血压和尿蛋白排泄量（UAER）、内生肌酐清除率（Cr-C）、血清肌酐（SCr）、血清尿素氮（BUN）及血、尿β2微球蛋白（β2-MG），采用彩色多普勒超声检查测量肾动脉管壁厚度及内径。结果拉西地平组和福辛普利组病人血压均较治疗前明显下降，2组间收缩压（SBP）、舒张压（DBP）比较无显著性差异（P〉0．05）；拉西地平组和福辛普利组病人血Cr、BUN治疗前后均无显著性差异（P〉0．05），2组病人治疗后UAER、Cr-C、血尿β2-MG均较治疗前显著性下降（P〈0．05）；拉西地平与福辛普利均能改善肾血管结构（P〈0．05）。福辛普利改善血管重构作用优于拉西地平（P〈0．01）。结论拉西地平和福辛普利均能良好降压，对高血压病人肾脏均有保护作用并能改善肾动脉重构。Objective To evaluate the effects of laeidipine and fosinopril on the renal function and renal arterial structure in hypertensive patients. Methods 106 hypertensive patients were randomized into lacidipine group （ n = 53 ） and fosinopril group （n =53）. The excretive rate of urinary albumin（ UAER）, the clearance endogenous ereatinine（Cr-C） ,and blood and urine β2 mieroglohulin（β2-MG） were detected before and after treatment. Results After treatment,blood pressure was significantly decreased in laeidipine and fosinopfil groups（ P 〈 0. 05 ）, and the levels of UAER, Cr-C, blood and urine β2-MG were significantly decreased （P 〈 0. 05 ）. Thickness of renal arterial wall was significantly decreased from 3.25 ± 0. 12 mm to 3. 08 ±0. 30 mm in laeidipine group （P 〈0. 05）, and from 3.27 ±0. 11 mm to 2.51 ±0. 72 mm in fosinopril group （P 〈 0. 01 ）. The renal arterial diameter was increased from 4. 17 ±0. 35 mm to 4. 32 ±0. 15 mm in laeidipine group （ P 〈 0. 05 ）, from 4. 16 ±0. 13 mm to 4. 71 ± 0. 52 mm in fosinopril group（P 〈 0. 01 ）. Conclusions Laeidipine and fosinopril are effective in reducing hypertension along with the protective effect on kidney in hypertensive patients.

关 键 词：高血压 肾 拉西地平 福辛普利 

分 类 号：R544.1[医药卫生—心血管疾病]