非洛地平缓释剂治疗肾移植术后高血压患者的中远期疗效观察(附37例报告)  

Long-term efficacy of felodipine palliative in treatment of hypertension after renal transplantation:a report of 37 cases

作　　者：詹胜利[1] 蔡明[1] 石炳毅[1] 李州利[1] 李鹏程[1] 

机构地区：[1]解放军总医院第二附属医院泌尿外科,北京100091

出　　处：《器官移植》2011年第3期162-164,180,共4页Organ Transplantation

基　　金：全军医药卫生科研基金(06G15)

摘　　要：目的研究非洛地平缓释剂治疗肾移植术后高血压患者的中远期疗效与安全性。方法 74例肾移植患者随机分为非洛地平缓释剂治疗组(研究组)和硝苯地平对照组(对照组)各37例。研究组给予口服非洛地平缓释剂,起始剂量为每次2.5mg,每日1次;对照组给予口服硝苯地平,起始剂量为每次10mg,每日3次。根据血压控制情况调整两组的降压药剂量。随访3年,观察两组移植术后1年、3年的人、肾存活率,血压、肾功能变化情况,环孢素(CsA)的血药浓度及剂量,以及不良反应发生情况。结果与对照组相比,研究组患者的1、3年人、肾存活率均明显提高(均为P<0.05)。研究组术后1年、3年的收缩压、舒张压均明显低于术前水平(P<0.05～P<0.01),且研究组术后3年的收缩压、舒张压均明显低于对照组(均为P<0.01)。两组术后1年、3年的血清肌酐(Scr)水平均明显低于术前水平(P<0.05～P<0.01),且术后3年研究组的Scr水平均明显低于对照组(P<0.01)。两组患者的CsA剂量与血药浓度比较差异无统计学意义(均为P>0.05)。两组的不良反应发生率比较差异亦无统计学意义(均为P>0.05)。结论非洛地平缓释剂用于肾移植术后高血压患者疗效较好,可明显提高移植术后1年、3年的人、肾存活率,改善中远期移植肾功能,且不影响CsA代谢,安全性良好。Objective To study the long-term efficacy and security of the felodipine palliative in treatment of hypertensive renal transplant recipients.Methods Seventy-four renal transplant recipients were randomly divided into 2 groups：felodipine palliative group（study group,n=37）and nifedipine control group（control group,n=37）.Study group received felodipine palliative 2.5 mg daily by oral administration.Control group received nifedipine 10 mg three times daily.The dosages of two drugs were adjusted according to blood pressure change.The 1 year and 3 year survival rate of patients/renal grafts,blood pressure,renal function,the blood concentration and dosage of ciclosporin（CsA）and incidence of untoward effects were observed in two groups.Results Compared with control group,the 1 year and 3 year survival rate of patients/renal grafts in study group were significantly higher（all in P0.05）.The systolic and diastolic pressure of study group at 1 year and 3 year after transplantation were significantly lower than that before transplantation（P0.05-P0.01）.And systolic and diastolic pressure in study group were significantly lower than that in control group at 3 year after transplantation（all in P0.01）.The serum creatinine（Scr）level of two groups at 1 year and 3 year after transplantation were significantly lower than that before transplantation（P0.05-P0.01）.And Scr level in study group was significantly lower than that in control group at 3 year after transplantation（P0.01）.There was no significant difference in blood concentration and dosage of CsA and incidence of untoward effects in two groups（all in P0.05）.Conclusions Felodipine palliative has good curative effect in hypertensive renal transplant recipients.It can improve the 1 year and 3 year survival rate of patients/renal grafts in the recipients of renal transplantation and long-term graft function.Felodipine palliative has good security and doesn＇t influence the metabolism of CsA.

关 键 词：肾移植 高血压 非洛地平 硝苯地平 肾功能 环孢素 

分 类 号：R544.105[医药卫生—心血管疾病]