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目的：观察培哚普利、卡托普利和硝苯地平对老年轻中度高血压患者肾功能的影响。方法：９４例老年轻中度高血压心室肥厚患者随机分为培哚普利、卡托普利和硝苯地平３组，服用２周安慰剂后用药３个月，剂量逐月递增。用药前后测定血压、尿微白蛋白分泌率（ＭＡＥＲ）、尿素氮、肌酐、肌酐清除率和血钾、血钠。结果：３组用药后血压均明显下降达正常范围；尿ＭＡＥＲ在培哚普利组显著下降（Ｐ＜０．０１），另两组下降不显著；尿素氮、肌酐、肌酐清除率３组治疗前后无明显变化；血钾在卡托普利组和培哚普利组均有上升（Ｐ＜０．００５和Ｐ＜０．０５），血钠水平３组间均无变化。结论：培哚普利、卡托普利和硝苯地平均可有效控制血压，培哚普利同时可降低尿ＭＡＥＲ，改善肾功能，但培哚普利与卡托普利均可引起血钾升高，应引起注意。
Objective: To observe the effect of perindopril, captopril and nifedipine on renal function in elderly patients with mild to moderate hypertension. Methods: A total of 94 elderly patients with mild to moderate hypertensive ventricular hypertrophy were randomly divided into three groups: perindopril, captopril and nifedipine. After two weeks of placebo, the patients were treated for 3 months and the dose was increased month by month. Before and after treatment, blood pressure, urine microalbumin secretion rate (MAER), urea nitrogen, creatinine, creatinine clearance and serum potassium, serum sodium. Results: The blood pressure of the three groups significantly decreased to the normal range. The urinary MAER decreased significantly in the perindopril group (P <0.01), and the other two groups did not decrease significantly. The levels of urea nitrogen, creatinine and creatinine clearance were significantly lower in the three groups There were no significant changes before and after; serum potassium increased in both captopril and perindopril groups (P <0.005 and P <0.05), and no change in serum sodium level among the three groups. CONCLUSION: Perindopril, captopril and nifedipine can effectively control blood pressure. Perindopril can reduce urinary MAER and improve renal function at the same time. However, both perindopril and captopril can cause hyperkalemia High, should attract attention.