| 培哚普利联合氨氯地平或氢氯噻嗪对老年高血压患者血压变异性的影响 |
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| 引用本文： | 徐亮,陈红武,陈燕春,赵祥海,季燕妮,张明,杨松.培哚普利联合氨氯地平或氢氯噻嗪对老年高血压患者血压变异性的影响[J].中华全科医学,2016,14(11):1892-1894. |
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| 作者姓名： | 徐亮 陈红武 陈燕春 赵祥海 季燕妮 张明 杨松 |
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| 作者单位： | 1. 宜兴市人民医院心血管内科, 江苏 宜兴 214200; |
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| 摘 要： | 目的 观察不同降压药物联合应用对老年高血压患者血压变异性(BPV)的影响。 方法 选择2015年1月—2016年1月宜兴市人民医院就诊的老年原发性高血压患者128例，将其按照随机数字法分为A、B两组，每组64例，A组给予氨氯地平和培哚普利；B组给予培哚普利和氢氯噻嗪；服药前及服药8周后均采用无创便携式动态血压监测仪监测24 h动态血压(动态收缩压及动态舒张压)，以测量值变异系数(CV)作为BPV的指标。 结果 服药8周后A组24 h平均收缩压(24hSBP)、白天平均收缩压(dSBP)、夜间平均收缩压(nSBP)、24 h平均收缩压变异系数(24hSCV)、白天平均收缩压变异系数(dSCV)、夜间平均收缩压变异系数(nSCV)均显著性低于B组(均P＜0.05)，但服药8周后2组24 h平均舒张压(24hDBP)、白天平均舒张压(dDBP)、夜间平均舒张压(nDBP)相比差异无统计学意义(均P＞0.05)，A组24 h平均舒张压变异系数(24hDCV)、白天平均舒张压变异系数(dDCV)、夜间平均舒张压变异系数(nDCV)显著低于B组(均P＜0.05)。服药8周后2组相比，A组一氧化氮水平显著高于B组，而内皮素水平显著低于B组(均P＜0.05)。 结论 氨氯地平联合培哚普利和氢氯噻嗪联合培哚普利均能有效降低老年原发性高血压患者血压变异性，但氨氯地平联合培哚普利效果更为明显。
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| 关 键 词： | 氨氯地平 培哚普利 氢氯噻嗪 血压变异性 高血压 |
| 收稿时间： | 2016-02-25 |
The influence of Perindopril combined with amlodipine or hydrochlorothiazide on senile hypertension patients blood pressure variability |
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| Affiliation: | Division of Cardiology, the People's Hospital of Yixing, Yixing, Jiangsu 214200, China |
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| Abstract: | Objective To observe the influence of different antihypertensive drugs combination on senile hypertension patients blood pressure variability. Methods From January 2015,to January,2016,128 cases of patients with senile primary hypertension in our hospital were chosen and randomly divided into A and B two groups(64 cases in each group).Group A were given 5 mg/d amlodipine and 4 mg/d perindopril,while group B were given 4 mg/d perindopril and 25 mg/d hydrochlorothiazide.Before taking the medicine and 8 weeks later noninvasive portable ambulatory blood pressure monitors were used to test 24 h ambulatory blood pressure (systolic blood pressure and dynamic diastolic blood pressure),and measure value coefficient of variation CV as an indicator of BPV. Results Eight weeks after taking medicine, indexes including 24 h mean systolic blood pressure(24hSBP),day mean systolic blood pressure(dSBP), night mean systolic blood pressure(nSBP),24 h mean systolic blood pressure coefficient of variation (24hSCV),day mean systolic blood pressure coefficient of variation (dSCV) and night mean systolic blood pressure coefficient of variation (nSCV) were significantly lower than that in group B(P<0.05).Eight weeks after taking medicine,24h mean diastolic blood pressure (24hDBP) day mean diastolic blood pressure (dDBP),night mean diastolic blood pressuren (DBP) in the two groups had no statistically significant difference(P>0.05).In the A group, 24 h mean diastolic blood pressure coefficient of variation (24hDCV),day mean diastolic blood pressure coefficient of variation (dDCV) and night mean diastolic blood pressure coefficient of variation(nDCV) were significantly lower than in the B group (all P<0.05).In group A,nitric oxide were significantly higher than that in group B,and while endothelin level was significantly lower than that in group B(P<0.05). Conclusion Amlodipine combined with perindopril and perindopril combined with hydrochlorothiazidel could all effectively reduce the elderly patients with essential hypertension blood pressure variability,but amlodipine combined with perindopril has more obvious effects. |
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