尼群洛尔的降压疗效和安全性  

Anti-hypertension effect and safety of nitrendipine/atenolol

作　　者：马丽媛[1] 王文[1] 陈伟伟[1] 刘明波[1] 邓卿[1] 刘力生[1] 

机构地区：[1]中国医学科学院阜外心血管病医院,北京100037

出　　处：《中国循证心血管医学杂志》2014年第2期149-152,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的观察尼群洛尔治疗高血压伴心血管危险因素患者的临床效果和安全性,并同时观察其对动态血压的影响。方法本研究是一项多中心随机对照临床试验。18～79岁伴心血管病危险因素的高血压患者在知情同意后进入研究。导入期2周,停用正在使用的降压药物。2周后门诊随访血压为收缩压（SBP）140～179 mmHg和（或）舒张压（DBP）90～109 mmHg者被随机分为尼群洛尔组（A组）或氨氯地平组（B组）。目标血压值为〈140/90 mmHg。随访中根据血压目标增加药物剂量或加其他降压药,治疗随访期6个月。基线、治疗4周和6个月时,各进行1次24小时（h）动态血压监测（ABPM）。研究过程中随时观察不良事件的发生情况。结果全国7个协作中心共随机入选207例高血压患者。治疗1个月后,两组的SBP和DBP就有显著下降,与治疗前相比差异非常显著（P〈0.01）,这种趋势一直持续至研究结束。治疗6个月时,尼群洛尔组和氨氯地平组血压分别显著下降18.9/9.2 mmHg和18.2/9.9 mmHg。治疗4周和6个月后,A、B组动态血压监测24 h,白昼和夜间血压均显著下降。治疗1个月时,二组血压达标率已近似50%,治疗6个月时均达到77%。研究过程中无严重不良事件报告。结论尼群洛尔可快速有效降低高危高血压患者血压水平,研究过程中未发现其对糖脂代谢的影响。Objective To observe the curative effect and safety of nitrendipine/atenolol in hypertensive patients with cardiovascular risk factors, and observe the influence of nitrendipine/atenolol on ambulatory blood pressure （BP）. Methods The study was a multicenter randomized controlled clinical trial. The hypertensive patients with cardiovascular risk factors aged from 18 to 79 were chosen into the trial after informed consent. In 2-w run-in period, all patients stopped their anti-hypertension durgs. After 2 w, the patients with SBP from 140 mmHg to 179 mmHg and/or DBP from 90 mmHg to 109 mmHg were randomly divided into nitrendipine/atenolol group （group A） and amlodipine besylate group （group B）. The target BP was〈140/90 mmHg, and during follow-up period （6 months）, the drug dose would be increased or other anti-hypertensive agents would be applied according to BP target. The patients were given a 24-h ambulatory blood pressure monitoring （ABPM） respectively at baseline and after treatment for 4 w and 6 months. The incidence of adverse events was observed at any time. Results There were totally 207 hypertensive patients included from 7 national cooperation centers. After treatment for 1 month, SBP and DBP decreased significantly in 2 groups and the difference was significant compared with before treatment （P〈0.01）, and this trend was continued to the end of the trial. After treatment for 6 months, BP decreased by 18.9/9.2 mmHg in group A and by 18.2/9.9 mmHg in group B. after tratmetn for 4 w and 6 months, 24-h ABPM showed that daytime and nighttime BP decreased significantly in 2 groups. BP control rate reached to 50%after treatment for 1 month and reached to 77%after treatment for 6 months. There were no adverse events reported during the trial. Conclusion Nitrendipine/atenolol can rapidly and effectively reduce BP level in patients with high-risk hypertension, and it has no impact on glucolipid metabolism.

关 键 词：高血压 动态血压 尼群洛尔 安全性 

分 类 号：R544.1[医药卫生—心血管疾病]