摘要
目的分析评价苯磺酸左旋氨氯地平联合氢氯噻嗪对老年高血压患者降压作用的稳定性。方法选取2003年10月至2004年5月首都医科大学附属北京安贞医院心内科老年原发性高血压病门诊患者54例,均每日苯磺酸左旋氨氯地平2.5mg及氢氯噻嗪12.5mg联合口服,平均疗程8周(包括安慰剂洗脱期2周),用药前及服药8周后复查动态血压监测,并记录内生肌酐清除率、尿微量白蛋白、左室心肌重量指数、射血分数、左室舒张早期充盈峰值流速与心房收缩期充盈峰值流速之比、颈动脉内径和内膜厚度等参数。结果(1)动态血压监测提示,与用药前比较,服药8周后平均收缩压和平均舒张压分别下降26.7mmHg和14.8mmHg,脉压差明显减小,差异具有显著性。(2)反映血压起伏变化的血压变异率和血压负荷,用药后明显降低。用药后收缩压、舒张压谷峰比值分别为76%和74%,明显高于用药前的63%和67%;反映昼夜节律的夜间血压下降率亦明显增高。(3)与用药前比较,服药8周后内生肌酐清除率、左室射血分数明显增加,而尿微量白蛋白、左室心肌重量指数、颈动脉内径和内膜厚度均明显减小。结论苯磺酸左旋氨氯地平联合氢氯噻嗪对老年高血压患者具有稳定的降压作用和明确的靶器官保护效应。
Objective To evaluate the smooth control effect of levamlodipine combined with hydrochlorothiazide in the aged patient with hypertension by the ambulatory blood pressure monitoring and the use of the randomized, control study methods. Methods From Oct. 2003 to May 2004, 58 cases were included in this study, 4 cases of which were excluded due to adverse effects. There fore, 54 cases of the old patients with essential hypertension （ mean age 69. 1±6 years） were included in this study, all cases being given levamlodipine combined wtih hydrochlorothiazide once daily for 8weeks. A24 - hour ambulatory blood pressure monitoring is performed, respectively at pre - treatment and after 8 - week treatment. Moreover, the data of Creatinine clearance rate （Ccr） and microalbuminuria （MAU） were tested, the ratio between early diastolic peak flow velocity and atrial peak flow velocity （ E/A）, ejection fraction （ EF）, left ventricular mass index （LVMI）, carotid arterial diameter （CAD）, and carotid arterial intimal medial thickness （IMT） were examined. Results （ 1 ） After 8 - week administration, the mean systolic and diastolic blood pressure decreased 26. 7 and 14. 8 mm Hg respectively. The pulse pressure also droped obviously. （2） The blood pressure variety ratio and blood pressure loading of the post- treatment decreased more than those of pre -treatment; the T/P ratio and the decreasing rate of night after the treatment increased higher than those of pre - treatment. （3） the Ccr, EF and E/A were significantly increased, while MAU, IMT, CAD and LVMI were decreased. Conclusion The analysis of ABPM showed that more smooth and effective blood pressure control could be gained with levamlodipine combined with hydrochlorothiazide in the old patients with hypertension. Meanwhile, the target organ protections were obtained.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2006年第6期814-816,共3页
Chinese Journal of Practical Internal Medicine
