各种降压药对原发性高血压患者动脉弹性功能的影响  

Effects of Various Antihypertensive Drugs on Arterial Elasticity in Patients with Essential Hypertension

作　　者：郑小蓉[1] 林金秀[1] 

机构地区：[1]福建医科大学附属第一医院心内科,福建福州350005

出　　处：《中华高血压杂志》2008年第5期404-407,共4页Chinese Journal of Hypertension

摘　　要：目的评价不同类型降压药对原发性高血压患者大小动脉弹性功能的影响。方法 105例1～2级原发性高血压患者,随机分为5组:氢氯噻嗪组(12.5 mg 1次/d,n=18)、比索洛尔组(5 mg 1次/d,n=20)、氨氯地平组(5 mg 1次/d,n=24)、苯那普利组(10 mg 1次/d,n=22)、缬沙坦组(80 mg 1次/d,n=21)。治疗4周后,如血压仍>140/90 mmHg,剂量加倍,疗程共12周。治疗前后观察大、小动脉弹性指数(C_1,C_2)及肱踝脉搏波传导速度(baPWV)。结果1)治疗12周后各组血压均有显著的降低,但各组间的血压变化无显著差别。比索洛尔组治疗后心率明显减慢[治疗后(66±4)比治疗前(74±7)次/mm,P<0.05]。2)调整血压降低幅度及 C_1、C_2、baPWV 基础值后,氨氯地平、苯那普利、缬沙坦对 C_1、C_2、baPWV 仍有显著性改善作用,比索洛尔及氢氯噻嗪对 C_1、C_2、baPWV则无显著性改善作用。3)baPWV 变化百分比与 DBP 下降幅度呈正相关(r=0.314,P<0.05),与 SBP 下降幅度无关(r=0.108,P>0.05)。结论与氢氯噻嗪、比索洛尔相比,氨氯地平、苯那普利、缬沙坦能明显改善高血压患者大小动脉弹性功能。Objective To evaluate the effects of various antihypertensive drug therapy on arterial elasticity in essential hypertension（ EH）. Methods One hundred and five patients with 1-2 grade EH were randomized to receive hydrochlorothiazide group（ 12. 5 mg/d, n= 18）, or bisoprolol （ 5 mg/d, n = 20 ）, or amlodipine （ 5 mg/d, n= 24 ）, or benazepril （ 10 mg/d, n= 22 ）, or valsartan （ 80 mg/d, n= 21 ） for 12 weeks. Four weeks after treatment, doses were titrated if BP≥140/90 mmHg. Large arterial Capacitive（C1 ）, small arterial oscillatory（C2 ） and baPWV （brachial-ankle pulse wave velocity） were determined in baseline and 12 weeks after treatment. Results BP were decreased significantly in all five groups with no significant differences among them （P〉0.05）. Heart rate was significantly slow in bisoprolol group（ after treatment： 66± 4 vs before treatment ： 74±7 beats/min, P〈0.05 ）. After adjusting for BP and the baseline value of C1, C2, baPWV, a significant reduction of the baPWV, increases in C1 and C2 were found in patients treated by amlodipine, benazepril and valsartan with no changes in patients treated by hydrochlorothiazide and bisoprolol. Correlation analysis showed decreases in baPWV was related with DBP only. Conclusion With similiar reduction effect on BP, arterial compliance improves after therapy with amlodipine benazepril and valsartan, but not bisoprolol and hydrochlorothiazide.

关 键 词：降压药 原发性高血压 动脉弹性 

分 类 号：R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]