阿雷地平治疗轻、中度原发性高血压患者动态血压评价  

The effects of aranidipine on ambulatory blood pressures in patients with mild to moderate essential hypertension

作　　者：陈莉[1] 姜红[1] 华琦[2] 杨汉跃 郑家通 金浩 焦媛[1] 王云[1] 孙瑞华[1] 柯元南[1] 

机构地区：[1]卫生部中日友好医院心内科,北京100029 [2]首都医科大学宣武医院 [3]江苏德源药业有限公司

出　　处：《中华内科杂志》2013年第9期749-752,共4页Chinese Journal of Internal Medicine

摘　　要：目的采用24h动态血压监测评价阿雷地平肠溶胶囊对轻、中度原发性高血压患者的降压疗效以及对血压变异性（BPV）的影响。方法开放试验。对74例符合入选标准的轻、中度高血压患者给予5mg／d阿雷地平肠溶胶囊，4周后如诊室坐位血压〈140／90mmHg（1mmHg=0．133kPa），维持原剂量治疗，血压未达标者剂量增至10mg／d。8周时诊室坐位血压〈140／90mmHg者，维持原剂量5mg／d或10mg／d，未达标者剂量增至20mg／d服药至第12周。在第0周、12周时分别各进行1次动态血压监测，观察治疗前后动态血压和BPV的变化。结果（1）阿雷地平肠溶胶囊治疗12周后，患者24h平均血压下降（14-．t-13）／（114-9）mmHg，较治疗前有显著降低（P〈0．05）；全部病例总体收缩压和舒张压谷峰（T／P）比值分别为75．31％和78．15％。（2）阿雷地平肠溶胶囊治疗12周后，患者24h、日间、夜间平均血压的标准差分别从（25±3）／（14±4）mmHg、（24±5）／（14±4）mmHg、（10±3）／（8±4）mmHg降至（11±3）／（8±2）mmHg、（11±3）／（8±2）mmHg、（8±3）／（6±3）mmHg，血压晨峰程度从（26±11）mmHg降至（19±9）mmHg，治疗前后差异均有统计学意义（P〈0．05）。（3）阿雷地平的不良反应发生率为13．4％，主要是轻度的头晕、面色潮红和心悸。结论阿雷地平肠溶胶囊治疗轻、中度原发性高血压患者不仅能有效降低24h血压，还能显著降低血压变异性，安全性良好。Objective To evaluate the effect of aranidipine enteric-coated capsules on 24 h blood pressure and blood pressure variability （ BPV ） in patients with mild to moderate essential hypertension. Methods This was an open clinical trial with 2 weeks of placebo run-in period. A total of 74 patients with blood pressure （140-180/95-110 mm Hg （1 mm Hg =0. 133 kPa）were treated by aranidipine （5 mg/d） for 4 weeks. If clinical sitting blood pressure 〈 140/90 mm Hg at 4th week, aranidipine at 5 mg/d would be continued for another 8 weeks. If not, the dosage would be increased to 10 mg/d. If blood pressure 〈 140/90 mm Hg at 8th week, aranidipine at 5 mg/d or 10 mg/d would be given constantly. If not, the dosage would be increased to 20 mg/d and given for another 4 weeks. All patients performed 24 h ambulatory blood pressure monitoring （ABPM） before and after the treatment with BPV evaluated by the average 24 h per unit time blood pressure standard deviation and morning blood pressure surge （ MBPS ）. Results （1） After 12 weeks＇ treatment with aranidipine, the mean 24 h blood pressure was reduced significantly compared with the baseline [ （ 14 ± 13 ） / （ 11± 9 ） mm Hg, both P 〈 0. 05 ] with trough/peak （T/P） ratio of SBP and DBP in responders of 75.31% and 78. 15%, respectively. （2） After 12 weeks＇ treatment, standard deviations of 24 h, daytime SBP/DBP and nighttime SBP/DBP were reduced significantly[（25±3）/（14±4） mm Hg vs （11 ±3）/（8±2） mm Hg, （24 ±5）/（14 ±4） mm Hg vs （11±3）/（8±2） mmHg, （10±3）/（8±4） mmHgvs （8±3）/（6±3） mm Hg, respectively with all P 〈 0. 05. Significant decrease was shown in MBPS compared to the baseline [ （27 ± 11 ） mm Hg vs （ 19 ±9） mm Hg, P 〈0. 051. （3） The incidence of adverse events was 13.4%, including mild dizziness, flushing and palpitation. Conclusion Administration of aranidipine enteric-coated capsules can control 24 h blood pressure effectively and reduce BPV significant

关 键 词：钙通道阻滞药 高血压 动态血压监测 

分 类 号：R544.1[医药卫生—心血管疾病]