中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
4期
22-24
,共3页
非洛地平%地尔硫(卓)%肾移植后高血压
非洛地平%地爾硫(卓)%腎移植後高血壓
비락지평%지이류(탁)%신이식후고혈압
Felodipine%Diltiazem%Hypertension after renal transplantation
目的 研究地尔硫(卓)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(卓)组(30例)；非洛地平组给予非洛地平2.5 mg日2次口服；地尔硫(卓)组给予地尔硫(卓)90 mg日1次口服.治疗过程中根据血压情况调整地尔硫(卓)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) mm Hg(1 mm Hg =0.133kPa)下降到(119.1±26.4)/(72.6±19.3) mm Hg;地尔硫(卓)革组血压从(152.0±7.6)/(95.4±6.9) mm Hg下降到(120.3±25.5)/(73.2±22.5)mm Hg,两组治疗前后血压比较差异无统计学意义(P＞0.05).地尔硫(卓)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(卓)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(卓)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.
目的 研究地爾硫(卓)與非洛地平治療腎移植後高血壓的降壓療效及降壓以外的作用.方法 60例以他剋莫司為基本免疫抑製治療的腎移植後高血壓患者,按隨機數字錶法分為非洛地平組(30例)和地爾硫(卓)組(30例)；非洛地平組給予非洛地平2.5 mg日2次口服；地爾硫(卓)組給予地爾硫(卓)90 mg日1次口服.治療過程中根據血壓情況調整地爾硫(卓)和非洛地平的用藥劑量或給藥次數.隨訪1年,比較兩組血壓、他剋莫司血藥濃度與劑量比值及腎功能的差異.結果 兩組患者均可以有效降低血壓,非洛地平組血壓從(153.6±7.5)/(97.7±6.7) mm Hg(1 mm Hg =0.133kPa)下降到(119.1±26.4)/(72.6±19.3) mm Hg;地爾硫(卓)革組血壓從(152.0±7.6)/(95.4±6.9) mm Hg下降到(120.3±25.5)/(73.2±22.5)mm Hg,兩組治療前後血壓比較差異無統計學意義(P＞0.05).地爾硫(卓)組治療後他剋莫司血藥濃度與劑量比值較治療前顯著升高[(173.2±59.3) g/L比(119.3±78.3) g/L](P＜ 0.05),而非洛地平組治療前後比較差異無統計學意義(P＞0.05).兩組治療前後血肌酐水平比較差異無統計學意義(P＞0.05).結論 腎移植後高血壓患者應用地爾硫(卓)和非洛地平降壓治療,均可使血壓達標.其療效和對腎功能的影響差異無統計學意義,但地爾硫(卓)可以使他剋莫司血藥濃度升高,更適閤用于治療腎移植後高血壓.
목적 연구지이류(탁)여비락지평치료신이식후고혈압적강압료효급강압이외적작용.방법 60례이타극막사위기본면역억제치료적신이식후고혈압환자,안수궤수자표법분위비락지평조(30례)화지이류(탁)조(30례)；비락지평조급여비락지평2.5 mg일2차구복；지이류(탁)조급여지이류(탁)90 mg일1차구복.치료과정중근거혈압정황조정지이류(탁)화비락지평적용약제량혹급약차수.수방1년,비교량조혈압、타극막사혈약농도여제량비치급신공능적차이.결과 량조환자균가이유효강저혈압,비락지평조혈압종(153.6±7.5)/(97.7±6.7) mm Hg(1 mm Hg =0.133kPa)하강도(119.1±26.4)/(72.6±19.3) mm Hg;지이류(탁)혁조혈압종(152.0±7.6)/(95.4±6.9) mm Hg하강도(120.3±25.5)/(73.2±22.5)mm Hg,량조치료전후혈압비교차이무통계학의의(P＞0.05).지이류(탁)조치료후타극막사혈약농도여제량비치교치료전현저승고[(173.2±59.3) g/L비(119.3±78.3) g/L](P＜ 0.05),이비락지평조치료전후비교차이무통계학의의(P＞0.05).량조치료전후혈기항수평비교차이무통계학의의(P＞0.05).결론 신이식후고혈압환자응용지이류(탁)화비락지평강압치료,균가사혈압체표.기료효화대신공능적영향차이무통계학의의,단지이류(탁)가이사타극막사혈약농도승고,경괄합용우치료신이식후고혈압.
Objective To study the therapeutic effect of diltiazem 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 Hgin 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 diltiazem 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 Diltiazem and felodipine can be used safely and effectively in the treatment of hypertension after renal transplantation,and diltiazem can lower the dose of tacrolimus.
