摘要
目的研究地尔硫革与非洛地平治疗肾移植后高血压的降压疗效及降压以外的作用。方法60例以他克莫司为基本免疫抑制治疗的肾移植后高血压患者，按随机数字表法分为非洛地平组（30例）和地尔硫革组（30例）；非洛地平组给予非洛地平2．5mg日2次121服；地尔硫革组给予地尔硫革90mg日1次口服。治疗过程中根据血压情况调整地尔硫革和非洛地平的用药剂量或给药次数。随访1年，比较两组血压、他克莫司血药浓度与剂量比值及肾功能的差异。结果两组患者均可以有效降低血压，非洛地平组血压从（153．6±7．5）／（97．7±6．7）mmHg（1mmHg=0．133kPa）下降到（119．1±26．4）／（72．6±19．3）mmHg；地尔硫革组血压从（152．0±7．6）／（95．4±6．9）mmHg下降到（120．3±25．5）／（73．2±22．5）mmHg，两组治疗前后血压比较差异无统计学意义（P〉0．05）。地尔硫革组治疗后他克莫司血药浓度与剂量比值较治疗前显著升高[（173．2±59．3）g／L比（119．3±78．3）g／L]（P〈0．05），而非洛地平组治疗前后比较差异无统计学意义（P〉0．05）。两组治疗前后血肌酐水平比较差异无统计学意义（P〉0．05）。结论肾移植后高血压患者应用地尔硫革和非洛地平降压治疗，均可使血压达标。其疗效和对。肾功能的影响差异无统计学意义，但地尔硫革可以使他克莫司血药浓度升高，更适合用于治疗。肾移植后高血压。
Objective To study the therapeutic effect of dihiazem and felodipine in treatment of hypertension after renal transplantation. Methods Sixty patients with hypertension after renal transplantation who were treated with tacrolimus as basic immunosuppressive therapy were divided into two groups by random digits table method with 30 cases each. The diltiazem group took diltiazem 90 mg orally once a day. The felodipine group received felodipine 2.5 mg orally twice a day. The drug dosages were adjusted according to the level of blood pressure. The patients were followed up for 1 year. The artery pressure,concentration-to-dose ratio of tacrolimus and renal function was detected and compared. Results Blood pressure was significantly decreased in both groups after 1 year treatment. Blood pressure was found to be significantly lowered from （ 153.6 ± 7.5）/ （97.7 ± 6.7） mm Hg （1 mm Hg = 0.133 kPa） to （119.1 ± 26.4）/ （72.6 ± 19.3） mm Hg in felodipine group; and from （ 152.0 ± 7.6）/（95.4 ± 6.9） mm Hg to （ 120.3 ± 25.5 ）/（73.2 ± 22.5） mm Hg in dihiazem group. There was no significant difference in blood pressure before and after treatment between two groups （P 〉 0.05）. The concentration-to-dose ratio of tacrolimus was increased after treatment in diltiazem group[ （ 173.2 ± 59.3） g/L vs. （ 119.3 ± 78.3） g/L] （P 〈 0.05） ,but there was no significant difference before and after treatment in felodipine group （P 〉 0.05 ）. The serum creatinine had no significant difference in two groups （P 〉 0.05 ）. Conclusion Dihiazem and felodipine can be used safely and effectively in the treatment of hypertension after renal transplantation, and diltiazem can lower the dose of tacrolimus.
出处
《中国医师进修杂志》
2013年第4期22-24,共3页
Chinese Journal of Postgraduates of Medicine
关键词
非洛地平
地尔硫?
肾移植后高血压
Felodipine
Diltiazem
Hypertension after renal transplantation
