尼卡地平控制性降压对原发性高血压患者围术期肾功能的影响

目的观察尼卡地平控制性降压对原发性高血压患者围术期肾功能的影响。方法择期行髋关节置换手术40例患者，随机分为尼卡地平组（N组）和对照组（C组），N组于手术开始时均通过上肢静脉微量泵输注降压药尼卡地平，输注速度从0．05μg／（kg·min）开始，逐渐增加输注速度直至患者血压降至目标血压水平分别于麻醉后降压前（T1）、降压稳定后30min（T2）和停止降压后30min（L）三个时间点分别测定血浆β2-微球蛋白（β2-MG）的浓度。结果血浆β2-微球蛋白N组T2时点较T1时点浓度升高（P〈0．05），T3时点与T1时点比较差异无统计学意义。结论尼卡地平可安全地应用于原发性高血压患者的控制性降压而不会加重已有的肾功能的损伤。

Effect of controlled hypotension with nicardipine on renal function of essential hypertensive patients during preioperation

Objective To investigate the effect of controlled hypotension with nicardipine on renal function of essential hypertensive patients during perioperation. Methods Forty ASA Ⅱ-Ⅲ scheduled patients undergoing elective surgery of total hip replacement were selected and divided randomly into two groups. Patients in group N （ n = 20） received nicardipine （ at 0. 05 -2 μg/kg/min） for induced hypotension dur/ng operation. Patients in groups C （ n = 20） received nothing during operation and keep the blood pressure stable. Aterial blood samples were taken from radial artery and β2-MG was measured and recorded at after anesthesia before induced hypotension（T1 ）. 30 min following induced hypotension to target pressure（T2 ）. 30 min after the end of induced hypotension（T3 ）. Results The level of β2-MG was higher than that of the normal. β2-MG was significant higher after controlled hypotension （ P 〈 0. 05 ）. There were no significant difference in β2-MG at T1, T3 in both groups（P 〉 0.05）. Conclusion Nicardipine can be safely used to sustain controlled hypotension during the operation（ total hip replacement）of essential hypertensive patients and cant hurt patients＇ renal function.