无创性动态血压监测评价复方坎地沙坦酯片治疗原发性高血压患者的疗效  

Antihypertensive Efficacy of Compound Candesartan Cilexetil/HTCZ Assessed by 24-hour Ambulatory Blood Pressure Monitoring in Patients With Essential Hypertension

作　　者：贾友宏[1] 明广华[1] 杨新春[2] 王莉[1] 边文彦[1] 庞会敏[1] 胡颖[1] 康健[1] 张阴凤[1] 刘红[1] 成小如[1] 方丽[1] 高明明[2] 李一石[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院卫生部心血管药物临床研究重点实验室,北京市100037 [2]首都医科大学附属朝阳医院

出　　处：《中国循环杂志》2007年第6期447-450,共4页Chinese Circulation Journal

摘　　要：目的:用无创性动态血压监测仪评价国产复方坎地沙坦酯片(坎地沙坦酯16 mg/氢氯噻嗪12.5 mg)对原发性高血压患者的降压疗效。方法:原发性高血压患者经过2周清洗期后,进入坎地沙坦酯片8 mg 单药治疗期,对4周后坐位血压未达标者(达标为血压<140/90 mmHg),进行24小时动态血压监测,以随机双盲、平行对照试验方法,分别服用复方坎地沙坦酯片(复方坎地沙坦酯组,28例)或16 mg 坎地沙坦酯片(坎地沙坦酯组,27例)治疗8周。比较两组服药前后24小时动态血压参数变化。观察组内与组间服药前后的不同时段的血压变化,谷峰比值及血压平滑指数。结果:共55例患者完成动态血压监测,两组基础指标比较无差异。复方坎地沙坦酯组与坎地沙坦酯组药后收缩压/舒张压/平均动脉压全日平均值(24小时)、日间平均值(6:00～22:00)、夜间平均值(22:00～6:00)均明显下降,与同组基线值比较均有极显著性差异(P<0.01)。组间比较,复方坎地沙坦酯组收缩压/舒张压/平均动脉压全日平均值(24小时)、日间平均值(6:00～22:00)、夜间平均值(22:00～6:00)的降低幅度与坎地沙坦酯组比较均有极显著性差异(P<0.01)。服药谷峰比值(SBP/DBP)复方坎地沙坦酯组分别为99.36%(19.16/19.28 mmHg)和87.36%(10.14/11.61 mmHg),复方坎地沙坦酯组分别为54.42%(7.30/13.41 mmHg)和64.86%(6.43/9.91 mmHg)。血压平滑指数(SBP/DBP)在复方坎地沙坦酯组为4.53/3.91,坎地沙坦酯组为1.29/1.52。结论:复方坎地沙坦酯片对原发性高血压患者有较好的降压作用,复方制剂比单药降压幅度大、持续时间长。动态血压平均下降幅度日间>全天>夜间,收缩压>舒张压。复方坎地沙坦酯控制血压更平稳。Objectives ： To compare the antihypertensive efficacies of candesartan cilexetil 16 mg/HTCZ12. 5 mg with candesartan cilexetil 16mg after 8 weeks treatment by 2d-hour ambulatory blood pressure monitoring（ABPM）. Methods： A randomized, double-blind, parallel-group study of Can/HTCZ （group 1 ） versus Can （group 2） was conducted in 55 patients with mild-to-moderate essential hypertension whose target sitting diastolic BP was not achieved （ SeDBP 〈 90 mmHg）after 4 weeks treatment with 8 mg candesartan cilexetil once-daily were undergone ABPM. Changes of daytime and night-time diastolic （DBP） and systolic blood pressures （SBP） by ABPM were compared. Tough peak ratio （TPR）and smoothness index （SI） were calculated for each group. Results： The mean BP（SBP/DBP） at 24h,daytime and night-time by ABPM in group 1 （n = 28 ） decreased by 15.86 ± 8. 24/8.75 ± 6. 23 mmHg, 17.04 ± 9. 60/10.00 ± 6. 87 mmHg and 14.61 ± 9.92/7.64 ± 7. 57 mmHg ; and in group 2 （ n = 27 ） decreased by 5.15 ± 7.67/4. 44 ± 4.59 mmHg,6. 70 ± 7. 12/5.26 ± 4.49 mmHg and 4. 11 ± 10.78/3.52 ± 6. 47 mmHg respeetively. The T/P ratio of SBP and DBP were 99.36% （ 19. 16/19. 28 mmHg） and 87.36% （ 10. 14/11.61 mmHg）in group 1 ; and 4.42% （7.30/ 13.41 mmHg） and 64. 86% （6.43/9.91 mmHg）in group 2 respectively. Conclusion：Compared with Can 16 mg,the compound Can 16 mg and HCTZ 12. 5 mg presented the better effect to the pa- tients with essential hypertension, and the compound product could reduce the blood pressure in a greater degree with longer time. The everage ambulatory blood pressure reducing model was like day time 〉 whole day 〉 night time, SBP 〉 DBP. The compound product may decease the blood pressure in a smoother way.

关 键 词：原发性高血压 复方坎地沙坦酯片 动态血压监测 谷峰比值 平滑指数 

分 类 号：R541[医药卫生—心血管疾病]