佩尔地平、卡托普利单独与联合应用对血压、血流动力学及左室重构影响  

The Effects of Nicardipine and Captopril Combined or Monotherapy on the BP, Hemodynamic and LV Remodeling in Hypertension

作　　者：朱轼[1] 秦方[1] 阮蕾[1] 阎亚非[1] 范丽明[1] 周兰春[1] 张静[1] 徐俊波[1] 王汝莲[1] 吴时达[1] 文瑞莲[1] 陈尔琴[1] 张廷杰[1] 

机构地区：[1]成都市第一人民医院

出　　处：《高血压杂志》1999年第2期113-116,共4页Chinese Journal of Hypertension

摘　　要：目的佩尔地平为新一代钙拮抗剂尼卡地平缓释剂，由于降压效果确切平稳，作用时间长，耐受好，对血脂，血糖无不良影响并为唯一可经胃肠道外给药的二氢吡啶类。本文采用随机对照研究评价佩尔地平单独及联合卡托普利的降压效果和对血流动力学与左室重构影响。方法采取随机，并行研究观察９０例男女高血压（血压≥１４０ｍｍＨｇ／９０ｍｍＨｇ，＜２００ｍｍＨｇ／１１０ｍｍＨｇ），年龄５０岁～７９岁，随机分入佩尔地平组（３０例），卡托普利组（３０例），佩＋卡组（３０例），随访３月～６月（中数随访５．２月），观察降压效果，血液动力学变化及左室重构效应。结果降压幅度佩组－２７．８ｍｍＨｇ／－１２．０ｍｍＨｇ，卡组－１４．２ｍｍＨｇ／－８．８ｍｍＨｇ，联用组－３０．９ｍｍＨｇ／－１４．０ｍｍＨｇ，控制率（血压＜１４０ｍｍＨｇ／９０ｍｍＨｇ）分别为７０％，４４％，７８％。撤药率（无效或副作用）分别为１／３０，５／３０，２／３０。治疗后佩组ＳＢＰ，ＤＢＰ，ＭＡＰ，ＴＰＲ显著改善，ＥＦ％及血管舒缩功能轻度改善，联合用药改善更全面明显。佩组及联合用药组ＬＶＭＩ明显降低，ＩＶＳＴ及ＬＶＰＷ亦微降，ＬＡ及ＬＶＤｄ影响较小。结论佩尔地平为安全，有效，耐受良好?Aim To compare the effects of nicardipine and/or captopril on the blood pressure, hemodynamic and left ventricular remodeling in treatment of hypertension. \ Methods \ In a randomized, single blind, parallel study, after a run in period, 90 patients BP140 mmHg/90 mmHg, <200 mmHg/110 mmHg,aged 50 yrs79 yrs were assigned to receive either nicardipine (n=30),captopril(n=30) alone or combined (n=30). The reduction of BP, changes in hemodynamic, and LV remodeling were observed. Results After a followup period of 3 months6 months (media 5.2 months), the decrease of blood pressure was -278 mmHg/-120 mmHg in nicardipine group, -142 mmHg/-88 mmHg in captopril group, and -309 mmHg/-140 mmHg in combined group, respectively The respone rate (BP<140 mmHg/90 mmHg) were 70%, 40%, 78% in each group The withdrawal rate due to nonresponse or adverse effect were 1/30, 5/30, 2/30 cases, respectively. Comparing to baseline value, SBP,DBP,MAP,TPR,EF% and vascular function were improved significantly in nicardipine group. IVST and LVPW reduced slightly. In combined therapy group, all of the parameters were improved significantly.WTHZConclusion Nicardipine alone and combined with captopril in treatment of hypertension were effective, safe and well tolerable.

关 键 词：佩尔地平 高血压 血流动力学 治疗 

分 类 号：R544.105[医药卫生—心血管疾病]