Pedersen O L, Krusell L R, Sihm I, Jespersen L T, Thomsen K
Department of Medicine I, Aarhus Amtssygehus, Denmark.
Am J Med. 1989 Apr 17;86(4A):15-8. doi: 10.1016/0002-9343(89)90184-8.
The hemodynamic and renal effects of isradipine were investigated in 10 hypertensive patients treated for 3.5 months and in a further nine patients treated for two years. Both groups achieved significant and sustained reductions in systolic blood pressure/diastolic blood pressure (-15 percent/-12 percent and -15 percent/-20 percent, respectively; p less than 0.001). Renal parameters were investigated two to three hours after the morning dose of isradipine, using a water-loading procedure. After 3.5 months of treatment, the glomerular filtration rate and renal plasma flow showed small increases (+6 percent and +9 percent, respectively, p less than 0.05), whereas, after two years, these changes were no longer present (+4 percent and 0 percent). Clearance of sodium and uric acid was increased by 40 percent (p less than 0.01) and 21 percent (p less than 0.01), respectively, after 3.5 months, and by 45 percent (p less than 0.05) and 23 percent (p less than 0.01), respectively, after two years. Lithium clearance studies revealed the natriuretic effect to be located in the proximal tubule. After 3.5 months, a significant relationship was found between the blood pressure response and the change in sodium excretion, but this relationship also was no longer present after two years. In conclusion, because of a maintained blood pressure-lowering effect while preserving renal function, and sustained natriuretic and uricosuric actions, isradipine can be considered a promising agent in the long-term treatment of arterial hypertension.
在10名接受治疗3.5个月的高血压患者和另外9名接受治疗两年的患者中，研究了伊拉地平的血流动力学和肾脏效应。两组患者的收缩压/舒张压均显著且持续降低（分别降低15%/12%和15%/20%；p<0.001）。在早晨服用伊拉地平两到三小时后，采用水负荷试验研究肾脏参数。治疗3.5个月后，肾小球滤过率和肾血浆流量略有增加（分别增加6%和9%，p<0.05），而两年后，这些变化不再存在（分别增加4%和0%）。3.5个月后，钠和尿酸清除率分别增加40%（p<0.01）和21%（p<0.01），两年后分别增加45%（p<0.05）和23%（p<0.01）。锂清除率研究表明利钠作用位于近端小管。3.5个月后，发现血压反应与钠排泄变化之间存在显著关系，但两年后这种关系也不再存在。总之，由于伊拉地平在维持降压效果的同时保留肾功能，并具有持续的利钠和促尿酸排泄作用，因此可被认为是长期治疗动脉高血压的一种有前景的药物。
