季节变化对长效钙离子拮抗剂降压效果的影响  

Influence of Seasonal Variation on Antihypertensive Effects of Long-acting Calcium Antagonists

作　　者：唐琼珍[1] 曹平良[1] 陈早芳[1] 卢寅辉[1] 胡杰[1] 刘建萍[1] 樊考林[1] 

机构地区：[1]江西省人民医院干部保健科,南昌330006

出　　处：《南昌大学学报（医学版）》2012年第1期36-40,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨季节变化对苯磺酸氨氯地平片与非洛地平缓释片降压效果的影响。方法将100例轻、中度高血压患者按不同的治疗方法分为F组和A组,每组50例。F组患者给予非洛地平缓释片5mg口服,1次.d-1;A组患者给予苯磺酸氨氯地平片5mg口服,1次.d-1。对2组患者冬、夏季各行动态血压监测(ambulatory bloodpressure monitoring,ABPM)1次,并检测血浆一氧化氮(NO)水平。结果 2组患者治疗后冬季24hSBP、白昼dSBP、夜晚nSBP均值均显著高于夏季(均P<0.05),F组患者治疗后冬、夏季24hSBP、dSBP、nSBP差值[(10.9±4.8)、(12.6±4.9)、(9.6±3.6)mmHg]均显著高于A组[(5.2±2.9)、(5.3±3.1)、(5.1±2.9)mmHg](均P<0.05)。F组患者治疗后冬季24hSBP、dSBP、nSBP、24hSBPSD、dSBPSD、nSBPSD均值均显著高于A组(均P<0.05)。A组患者治疗后冬、夏季血压晨峰均值[(34.6±10.1)、(34.3±8.9)mmHg]均显著低于F组[(38.8±11.3)、(36.1±9.8)mmHg](均P<0.01)。A组患者治疗后冬季24h、白昼、夜间ABPM血压达标率(78.6%、76.5%、78.6%)均显著高于F组(53.7%、58.5%、46.3%)(均P<0.01)。A组患者治疗后冬、夏季血浆NO水平[(57.32±10.37)、(64.26±11.62)μmol.L-1]均显著高于F组[(48.74±12.10)、(55.21±9.86)μmol.L-1](均P<0.05)。结论苯磺酸氨氯地平片较非洛地平缓释片使血压季节差异更小,平稳性更高,达标率更高,更有助于保护血管内皮功能。Objective To explore the influence of seasonal variation on antihypertensive effects of amlodipine besylate tablets and felodipine extended-release tablets.Methods One hundred patients with mild to moderate hypertension were treated with oral felodipine extended-release tablets（group F,n=50） or amlodipine besylate tablets（group A,n=50） 5 mg once daily.Ambulatory blood pressure monitoring（ABPM） was performed once in summer and once in winter and plasma concentrations of nitric oxide（NO） were detected in both groups.Results After treatment,the 24 hour-blood pressure（24 h SBP）,daytime systolic blood pressure（dSBP） and nighttime systolic blood pressure（nSBP） in winter were significantly higher than those in summer in both groups（all P0.05）.The difference values for 24 h SBP,dSBP and nSBP between winter and summer in group F[（10.9±4.8）,（12.6±4.9） and（9.6±3.6）mmHg,respectively]were larger than those in group A[（5.2±2.9）,（5.3±3.1） and（5.1±2.9）mmHg,respectively]（all P0.05）.Furthermore,the mean values for 24 h SBP,dSBP,nSBP,24 h SBPSD,dSBPSD and nSBPSD in winter in group F were higher than those in group A（all P0.05）.The morning blood pressure surge was（34.6±10.1） mmHg in winter and（34.3±8.9） mmHg in summer in group A and（38.8±11.3） mmHg and（36.1±9.8） mmHg in group F,and differences were significant（all P0.01）.The standard-eaching rates of 24 h SBP,dSBP and nSBP ABPM in group A（78.6%,76.5% and 78.6%,respectively） were higher than those in group F（53.7%,58.5% and 46.3%,respectively）（all P0.01）.Moreover,plasma concentrations of NO were（57.32±10.37） μmol·L-1 in winter and（64.26±11.62） μmol·L-1in summer in group A and（48.74±12.10）μmol·L-1and（55.21±9.86）μmol·L-1in group F,and differences were significant（all P0.05）.Conclusion Amlodipine besylate tablets for blood pressure have smaller seasonal differences,better stability and higher standard-reaching rates and provide better protection for v

关 键 词：高血压病 钙离子拮抗剂 血压变异性 动态血压监测 苯磺酸氨氯地平片 非洛地平缓释片 冬季 夏季 

分 类 号：R544.1[医药卫生—心血管疾病]