两种降压药物治疗老年清晨高血压的效果及对血压变异性、超声心动图指标的影响  

Curative Effect of Two Anti-hypertensive Drugs on Morning Hypertension and Influences on Blood Pressure Variability and Ultrasonic Cardiogram Indexes in the Elderly

作　　者：陆子华 LU Zihua(Jiujiang University Affiliated Hospital,Jiujiang Jiangxi 332000,China)

机构地区：[1]九江学院附属医院,江西九江332000

出　　处：《药品评价》2023年第2期195-199,共5页Drug Evaluation

摘　　要：目的 探讨两种降压药物治疗老年清晨高血压的效果及对血压变异性(BPV)、超声心动图(UCG)指标的影响。方法 选取2019年2月至2021年2月九江学院附属医院收治的老年清晨高血压患者86例,通过随机数字表法将其分为A组和B组,各43例,A组予以苯磺酸氨氯地平口服治疗,B组采用贝那普利口服治疗。连续治疗3个月后,比较两组患者疗效;比较治疗前后两组患者24 h动态血压、BPV、UCG指标、血管内皮及肾脏功能变化;比较治疗期间两组患者不良反应发生情况。结果 连续治疗3个月后,两组患者清晨收缩压(SBP)、舒张压(DBP)较治疗前均明显降低,且A组明显高于B组(P<0.05),A组治疗总有效率明显高于B组(P<0.05);两组患者日间、夜间及24 h的SBP、DBP、血压晨峰、收缩压变异性(SBPV)、舒张压变异性(DBPV)、左心室质量指数(LVMI)以及左心室后壁厚度(LVPWT)较治疗前均明显减低(P<0.05),治疗后两组患者相关血压、BPV及UCG各项指标差异无统计学意义(P>0.05);治疗后两组患者内皮素(ET)及尿微量白蛋白与尿肌酐比值(UACR)较治疗前均明显降低,一氧化氮(NO)水平较治疗前均明显提升(P<0.05),且治疗后B组患者UACR水平低于A组(P<0.05);治疗期间两组患者均未出现严重不良反应(P>0.05)。结论 苯磺酸氨氯地平和贝那普利治疗老年清晨高血压均可有效控制患者昼夜血压,改善其血压变异性,缓解心室和血管内皮损伤,且安全性均较高;苯磺酸氨氯地平对清晨血压水平的控制效果更显著,而贝那普利对肾脏的保护作用更明显。Objective To explore the curative effect of two anti-hypertensive drugs on morning hypertension and influences on blood pressure variability(BPV)and ultrasonic cardiogram(UCG)indexes in the elderly.Methods A total of 86 elderly patients with morning hypertension admitted to Jiujiang University Affiliated Hospital were enrolled between February 2019 and February 2021.According to random number table method,patients were divided into group A(oral amlodipine besylate)and group B(oral benazepril),43 cases in each group.After 3 months of continuous treatment,curative effect between the two groups was compared.The changes in 24 h ambulatory blood pressure,BPV,UCG indexes,vascular endothelial and renal function before and after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results After 3 months of continuous treatment,morning systolic blood pressure(SBP)and diastolic blood pressure(DBP)in both groups were significantly lower than those before treatment,which were significantly higher in group A than group B(P<0.05).The total response rate of treatment in group A was significantly higher than that in group B(P<0.05).After treatment,SBP,DBP,morning blood pressure spike,systolic blood pressure variability(SBPV),diastolic blood pressure variability(DBPV),left ventricular mass index(LVMI)and left ventricular posterior wall thickness(LVPWT)of daytime,nighttime and 24 h were significantly lower than those before treatment in both groups(P<0.05).After treatment,there was no significant difference in blood pressure,BPV and UCG indexes between the two groups(P>0.05).After treatment,endothelin(ET)and urine albumin/creatinine ratio(UACR)were significantly decreased,while nitric oxide(NO)was significantly increased in both groups(P<0.05).After treatment,UACR level in group B was significantly lower than that in group A(P<0.05).During treatment,there was no serious adverse reaction in either group(P>0.05).Conclusion Both amlodipine besylate and benazepril can effectively cont

关 键 词：高血压 苯磺酸氨氯地平 贝那普利 清晨高血压 血压变异性 超声心动图 

分 类 号：R544.1[医药卫生—心血管疾病]