比较国产马尼地平和氨氯地平对原发性高血压治疗效果的评价  

Comparison of the effects of domestic manidipine and amlodipine in the treatment of essential hypertension

作　　者：赵荫涛[1] 杨莹莹 宋毅[2] 郑璐[1] 刘源[1] 杨海波[1] ZHAO Yintao;YANG Yingying;SONG Yi;ZHENG Lu;LIU Yuan;YANG Haibo(Department of Cardiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China;Department of Ultrasound,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第一附属医院心血管内科,河南郑州450052 [2]郑州大学第一附属医院超声科,河南郑州450052

出　　处：《安徽医药》2023年第4期669-673,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河南省科技攻关基金资助项目(182102310099)。

摘　　要：目的比较国产马尼地平与氨氯地平对原发性轻中度高血压病人降压效果、动脉弹性和尿微量白蛋白(MAU)的影响。方法选取郑州大学第一附属医院2020年5月至2021年6月门诊和住院就诊的260例新发轻中度高血压病人纳入本研究,随机数字表法分为马尼地平组和氨氯地平组,马尼地平组口服国产马尼地平10 mg/d和氨氯地平模拟剂,氨氯地平组口服氨氯地平5 mg/d和马尼地平模拟剂,1个月后血压高于140/90 mmHg病人,服用药物剂量加倍。服药前和服药2、6个月后分别检测动脉弹性指标:肱踝动脉传导速度(baPWV)、大动脉弹性指数C1和小动脉弹性指数C2,以及MAU。结果降压治疗2个月后马尼地平组和氨氯地平组收缩压(SBP)[(134.16±13.25)mmHg比(156.32±15.36)mmHg,(132.96±14.80)mmHg比(155.49±17.67)mmHg]较治疗前明显降低(P<0.05),舒张压(DBP)[(84.43±7.63)mmHg比(103.08±10.17)mmHg,(83.86±7.82)mmHg比(100.41±10.40)mmHg]较治疗前也明显降低(P<0.05)。马尼地平组血压达标率83.84%,氨氯地平组血压达标率90.00%,两组间差异无统计学意义。baPWV在治疗2个月后马尼地平组(1790.18±399.34)cm/s和氨氯地平组(1746.85±374.46)cm/s较治疗前(1958.99±514.85)cm/s、(2071.50±552.95)cm/s明显降低(P<0.05),治疗6个月后较治疗2个月后两组baPWV进一步降低[(1557.27±359.06)cm/s比(1790.18±399.34)cm/s,(1599.46±346.61)cm/s比(1746.85±374.46)cm/s,P<0.05]。大动脉弹性指数C1在治疗6个月后与治疗前比较,马尼地平组和氨氯地平组均明显升高(P<0.05)。小动脉弹性指数C2在治疗2个月后,马尼地平组较治疗前明显升高(P<0.05),对比治疗前,治疗6个月后马尼地平组和氨氯地平组均明显升高(P<0.05),两组小动脉弹性指数C2在治疗6个月后均较治疗2个月后进一步降低(P<0.05)。MAU在马尼地平组治疗2、6个月后较治疗前明显下降(P<0.05),并且治疗6个月后比治疗后2个月后进一步降低(P<0.05)。氨氯地平组治疗�Objective To compare the effects of domestic manidpine and amlodipine on antihypertensive effects,arterial elasticity and urinary microalbumin(MAU)in patients with primary mild to moderate hypertension.Methods A total of 260 patients with newonset mild to moderate hypertension admitted to The First Affiliated Hospital of Zhengzhou University from May 2020 to June 2021 in both outpatient and inpatient settings were selected for inclusion in this study and were divided into the manidipine and amlodipine groups by the random number table method.The manidipine group received oral domestic manidipine 10 mg/d and amlodipine mimetic,and the amlodipine group received oral amlodipine 5 mg/d and manidipine mimetic.Patients with blood pressure above 140/90 mmHg after 1 month were given double the dose of the drug.Arterial elasticity indices were measured before and after 2 and 6 months of drug administration:brachial-ankle pulse wave velocity(baPWV),large artery elasticity index C1 and small artery elasticity index C2,and microalbuminuria(MAU).Results After 2 months of antihypertensive treatment,systolic blood pressure(SBP)[(134.16±13.25)mmHg vs.(156.32±15.36)mmHg,(132.96±14.80)mmHg vs.(155.49±17.67)mmHg]was significantly lower in the manidipine and amlodipine groups compared to pretreatment(P<0.05),and diastolic blood pressure(DBP)[(84.43±7.63)mmHg vs.(103.08±10.17)mmHg,(83.86±7.82)mmHg vs.(100.41±10.40)mmHg]was also significantly lower than before treatment(P<0.05).The blood pressure compliance rate was 83.84%in the manidipine group and 90.00%in the amlodipine group,with no statistically significant difference between the two groups.BaPWV was significantly decreased in the two groups[(1790.18±399.34)cm/s vs.(1958.99±514.85)cm/s,(1746.85±374.46)cm/s vs.(2071.50±552.95)cm/s]after 2 months of treatment(P<0.05).BaPWV was further reduced in both groups after 6 months of treatment compared to after 2 months of treatment[(1557.27±359.06)cm/s compared to(1790.18±399.34)cm/s and(1599.46±346.61)cm/s compared to(1746.

关 键 词：高血压 马尼地平 动脉 弹性 尿蛋白 氨氯地平 

分 类 号：R544.11[医药卫生—心血管疾病]