中国临床药学杂志

目的:评价拉西地平对原发性高血压患者肾脏的作用.方法:18例原发性高血压病住院患者(男16例,女2例),血压(23±2/14±1)kPa[(169±13/108±9)mmHg],分别在停降压药1～2wk.低钠饮食(20mmol/d)×5d,高钠饮食(26mmol/d)×5d及服用拉西地平(4～6mg/d)×4wk,测定肾小球滤过率(GFR内生肌酐清除率),同位素肾血流量(RPF),尿微量白蛋白排泄率(UMAE)及视黄醛结合蛋白排泄率(URE).结果:低钠比高钠状态UMAE显著下降(P<0.01),服拉西地平后GFR、RPF均有增加,但不显著.在GFR由(127±43)上升到(143±36)ml/min时UMAE明显减少(26.2mg/24h到15.0mg/24h,P<0.05),结论:拉西地平不降低原发性高血压病病人的肾功能,并能减少UMAE;减少UMAE可能与肾血流动力学改变无关.

AIM:To evaluate the renal effect of new dihydropyridine of calcium antagonists, lacidipine in essential hypertensive patients,METHODS:Eighteen inpatients with moderate essential hypertension [male 16,female 2, average age(52 ±6)a]were submitted to a low-salt diet (20mmol of Na/day for 5 days),a high-salt diet (260mmol of Na/day for 7 days) and normal salt diet (160mmol of Na/day for 4 weeks) with the administration of lacidipine(4~6mg/d)after 1² weeks untreated. After above periods,all patients were examined with laboratory investigation that included glomerular filtration rates (GFR), renal plasma flows (RPF), urinary microalbumin excretion rate (UMAE)and urinary ratinal binding protein excretion rate (URE). RESULTS: ①UMAE decreased significantly under low-salt diet (P<0. 01). ② GFR and RPF had increased tendency but not significantly change after the administration of lacidipine. ③ UMAE decreased significantly (from 26. 2mg/24h to 15. 0mg/24h.P<0. 05)while GFR had increased tendency [from (127±43 ) to (143 ± 36)ml/min], CONCLUSION :Lacidipine did not impair renal function but decrease UMAE which seems to be not correlated with renal hemodynamics.