Acone D, Cante D, Cillo F, Giordano G, Giordano C
Institute of Internal Medicine and Nephrology, II University of Naples, Italy.
Kidney Int Suppl. 1996 Jun;55:S75-7.
There are a lack of studies about elderly patients with chronic renal failure (CRF). We studied 22 patients, aged 64 to 74 years, who were diagnosed with hypertensive nephropathy (HN), defined as a diastolic blood pressure (DBP) < 95 mm Hg and a basal creatinine clearance (CCr) of 52 +/- 6 ml/min/1.73 m2. During the minimum two-year follow-up, the progression of renal failure (RF) was analyzed by the plotted slope of CCr versus time. Patients were divided into two groups, each administered one of two different drugs, Ca antagonists (group I) and angiotensin converting enzyme (ACE) inhibitors (group II). The DBP in both groups was lowered by the end of the study. The mean arterial pressure (MAP) was less in group I (97.35 +/- 5.98 mm Hg) than in group II (108.3 +/- 9.95 mm Hg). The decline in renal function was a mean rate of -0.62 +/- 0.36 ml/min/month in group I and -1.03 +/- 0.17 ml/min/month in group II. In conclusion, we show that patients who were on ACE inhibitors exhibited a greater MAP and a greater decline in renal function compared with the patients who were on Ca antagonist therapy. We also found that patients who were younger than 70 years old had better control of their blood pressure rates and less of a rate of decline in renal function than their older counterparts.
关于老年慢性肾衰竭（CRF）患者的研究较少。我们研究了22名年龄在64至74岁之间、被诊断为高血压肾病（HN）的患者，高血压肾病定义为舒张压（DBP）<95mmHg且基础肌酐清除率（CCr）为52±6ml/min/1.73m²。在至少两年的随访期间，通过绘制CCr与时间的斜率来分析肾衰竭（RF）的进展情况。患者被分为两组，分别给予两种不同药物中的一种，钙拮抗剂（I组）和血管紧张素转换酶（ACE）抑制剂（II组）。到研究结束时，两组的DBP均有所降低。I组的平均动脉压（MAP）（97.35±5.98mmHg）低于II组（108.3±9.95mmHg）。I组肾功能下降的平均速率为-0.62±0.36ml/min/月，II组为-1.03±0.17ml/min/月。总之，我们发现与接受钙拮抗剂治疗的患者相比，接受ACE抑制剂治疗的患者表现出更高的MAP和更大的肾功能下降。我们还发现，年龄小于70岁的患者比年龄较大的患者血压控制更好，肾功能下降速率更低。
