苯那普利、非洛地平和硝苯地平对高血压病患者血压和肾功能的影响

目的:比较苯那普利、非洛地平与硝苯地平对高血压病患者血压和肾功能的影响。方法:90例高血压病患者随机分成3组:苯那普利组(30例,10mg,1次/d),非洛地平组(30例,5mg,1次/d),硝苯地平组(30例,10mg,3次/d),疗程24周,治疗前、后观察偶测血压和动态血压(24h平均血压,白天平均血压,夜间平均血压)及肾功能变化。结果:苯那普利组和非洛地平组治疗后,偶测血压和动态血压及血、尿β_2微球蛋白,24h尿微量白蛋白均显著降低(P<0.01),硝苯地平组治疗后偶测血压和白天平均血压明显下降(P<0.01),夜间平均血压及24h平均血压下降幅度小,与苯那普利组和非洛地平组比较差异显著(P<0.01)。硝苯地平组治疗后肾功能各项指标无明显变化(P>0.05)。结论:苯那普利和非洛地平能有效降低高血压病患者血压和改善肾功能,而硝苯地平不能平稳降压,无肾脏保护作用。

Effect of Benazepril, Felodipine and Nifedipine on Blood Pressure and Renal Function in Patients with Essential Hypertension

Objective: To compare the effect of benazepril, felodipine and nifedipine on blood pressure and renal function in patients with essential hypertension (EH).Method: 90 patients with EH were randomly divided into 3 groups: benazepril group(10mg P.O.each day, n = 30), felodipine group (5mg P. O. each day, n = 30), nifedipine group(10mg P.O.3times a day, n = 30). The changes of office blood pressure, ambulatory blood pressure and renal function were observed before and after treatment, the total treatment course was 24 weeks.Results:Office blood pressure, ambulatory blood pressure,blood and urine β2-MG level,24-hour mi-croalbuminuria levels were significantly decreased in benazepril group and nifedipine group after treatment. After treatment in nifedipine group, office blood pressure and average day blood pressure were significantly decreased( P< 0.01), but average 24-hour and night blood pressure had no significant changes.To compare nifedipine group with benazepril group and felodipine group, the difference was very significant in average 24-hour and night blood pressure( P < 0.01). Each criteria of renal function had no significant changes after treatment in nifedipine group( P > 0.05). Conclusion: Both benazepril and felodipine can effectively control blood pressure, and improve renal function,but nifedipine can't.