两种钙离子拮抗剂联用治疗尿毒症合并难治性高血压的临床研究

目的：探讨联用两种钙离子拮抗剂（calciumchannelblocker，CCB）治疗尿毒症合并难治性高血压的临床疗效。方法：选择广东省湛江市廉江市人民医院血液净化中心2010年10月至2011年9月收治的72例终末期肾病维持性血液透析合并难治性高血压患者作为观察对象，并随机分为A、B、C三组，每组24例，A组和B组病分别用硝苯地平缓释片和苯磺酸氨氯地平治疗8周，C组联合应用硝苯地平缓释片和苯磺酸氨氯地平治疗8周，观察各组血压变化情况及不良反应的发生情况。结果：C组病例治疗完成时收缩压、舒张压、平均动脉压较A组和B组病例治疗前的血压明显降低，总有效率明显高于A组和B组，差异有统计学意义（P〈0．05）。三组治疗过程中，均无严重不良反应发生。结论：联合应用两种CCB治疗尿毒症顽固性高血压，降压效果明显，且可耐受性好。

Clinical Research on Effect of Treatment by Two Kinds of Calcium Channel Blocker on Refractory Hypertension Caused by Uremia

Objective： To study the effect of treatment by two kinds of calciumchannel blocker on refractory hypertension caused by uremia. Methods： 48 cases of end-stage renal disease maintenance hemodialysis with intractable high blood pressure hospitalized in LianJiangShi zhanjiang, guangdong people＇s hospital blood purification center from October 2010 to September 2011 were selected and randomly divided into group A, B and C, patients in group A and group B were treated with nifedipine and benzene sulfonic acid amlodipine respectively for 8 weeks, patients in group C were treated with both nifedipine and benzene sulfonic acid amlodipine. Results： The systolic blood pressure, diastolic blood pressure, mean arterial pressure of group C after treatment were all significantly lower than those of group A and B. while the effective rate was significantly higher than group A and B （P〈0.05）. No serious adverse reaction was observed during the treatment. Conclusions： Combined application of two kinds of on refractory hypertension caused by uremia could be well tolerated and effectively lower blood pressure.