苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病患者血压变异性、血压晨峰现象的影响  

Effect of amlodipine besylate tablets combined with metoprolol tartrate tablets on blood pressure variability and blood pressure morning peak phenomenon in elderly patients with morning peak hypertension combined with coronary heart disease

作　　者：王鸿权 WANG Hongquan(Department of Cardiology,Xinyang People's Hospital in Henan Province,Xinyang,Henan 464000,China)

机构地区：[1]河南省信阳市人民医院心内科,河南信阳464000

出　　处：《检验医学与临床》2024年第3期363-367,共5页Laboratory Medicine and Clinic

摘　　要：目的分析苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病患者血压变异性(BPV)、血压晨峰(MBPS)现象的影响。方法按照随机数字表法将该院2020年2月至2023年2月收治的84例老年晨峰高血压合并冠心病患者分为对照组和研究组,每组42例。对照组采用苯磺酸氨氯地平片进行治疗,研究组采用苯磺酸氨氯地平片联合酒石酸美托洛尔片进行治疗。比较两组临床疗效、治疗前后收缩压(SBP)、舒张压(DBP)、BPV[包括24 h SBP、24 h DBP、24 h SBP标准差(24 h SSD)、24 h DBP标准差(24 h DSD)]、MBPS、冠状动脉病变程度(以Gensini积分评估)、肾功能相关指标[24 h尿微量清蛋白(24 h MAU)、尿清蛋白与肌酐比值(ACR)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)]水平、炎症相关指标[可溶性血管黏附因子-1(sVCAM-1)、金属蛋白酶-9(MMP-9)]水平及外周血单个核细胞核因子-κB(NF-κB)p65阳性率。结果研究组临床总有效率为95.24%,高于对照组的78.57%(P<0.05);治疗后研究组24 h DBP、24 h SBP、24 h DSD、24 h SSD低于对照组(P<0.05);治疗后研究组MBPS、Gensini积分低于对照组(P<0.05);治疗后研究组24 h MAU、HDL-C、TC、TG水平及ACR均低于对照组(P<0.05);治疗后研究组sVCAM-1、MMP-9水平及NF-κBp65阳性率均低于对照组(P<0.05)。结论苯磺酸氨氯地平片联合酒石酸美托洛尔片对老年晨峰高血压合并冠心病疗效确切,可有效降低患者BPV、MBPS,减轻血管炎症反应,改善肾功能,促进冠状动脉病变恢复。Objective To analyze the effects of amlodipine besylate tablets combined with metoprolol tartrate tablets on the phenomenon of blood pressure variability(BPV)and morning blood pressure surge(MBPS)in elderly patients with morning peak hypertension combined with coronary heart disease.Methods A total of 84 elderly patients with morning peak hypertension combined with coronary heart disease admitted to the hospital from February 2020 to February 2023 were divided into the control group and the study group according to random number table method,42 cases in each group.The control group was treated with amlodipine besylate tablets,and the study group was treated with amlodipine besylate tablets combined with metoprolol tartrate tablets.The clinical efficacy of the two groups was compared,as well as the systolic blood pressure(SBP),diatolic blood pressure(DBP),BPV(including 24 h SBP,24 h DBP,24 h SSD and 24 h DSD),MBPS,degree of coronary artery disease(evaluated by Gensini score),renal function related indicators[24-hour urinary microalbumin(24 h MAU),urinary albumin and creatinine ratio(ACR),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)]levels,inflammation related indicators[soluble vascular intercellular adhesion factor-1(sVCAM-1),metalloproteinase-9(MMP-9)]levels,and peripheral blood mononuclear factor-κB(NF-κB)p65 positive rate before and after treatment.Results The total effective rate of the study group was 95.24%,which was higher than 78.57% of the control group(P<0.05).After treatment,the 24 h DBP,24 h SBP,24 h DSD and 24 h SSD of the study group were lower than those of the control group(P<0.05).After treatment,the MBPS and Gensini score in the study group were lower than those in the control group(P<0.05).After treatment,the levels of 24 h MAU,HDL-C,TC,TG and ACR of the study group were lower than those of the control group(P<0.05).After treatment,the positive rates of sVCAM-1,levels of MMP-9 and NF-κBp65 in the study group were lower than those in the control group(P<

关 键 词：晨峰高血压 冠心病 苯磺酸氨氯地平 酒石酸美托洛尔 血压变异性 老年 

分 类 号：R541.4[医药卫生—心血管疾病] R544.1[医药卫生—内科学]