培哚普利与氨氯地平对轻中度高血压患者血管弹性作用的比较

目的 比较培哚普利、氨氯地平两种降压药在改善高血压患者动脉弹性功能方面的差异.方法 78例高血压患者被随机分成培哚普利组(38例)和氨氯地平组(40例),每组有36例纳入最终统计数据,在服药前和服药1个月、6个月后应用科林波形分析仪PWV/ABI型仪器测量患者的臂踝脉搏波传导速度.结果 降压治疗后两组的收缩压、舒张压和脉压差均较治疗前明显降低(P<0.01);心率则未见明显变化.臂踝脉搏波传导速度在培哚普利组和氨氯地平组治疗1个月后(分剐为1 572.92±230.08 cm/s和1 542.31±227.59 cm/s)及治疗6个月后(分别为1 484.92±226.59 cm/s和1 432.50±217.88 cm/s)与治疗前(分别为1 737.39±275.99 cm/s和1 765.50±294.57 cm/s)比较均有所下降(P<0.001);且治疗6个月比治疗1个月下降更显著(P<0.001).与培哚普利组比,氨氯地平组降压治疗1个月后臂踝脉搏波传导速度变化值(223.19±200.65 cm/s比164.47±104.18 cm/8)及降压治疗6个月后变化值(333.00±227.36 cm/s比252.47±141.26 cm/s)更显著(P<0.01);降压治疗6个月后与降压治疗1个月后比较,两组臂踝脉搏波传导速度均有进一步的下降(P<0.001).结论 培哚普利和氨氯地平均能改善高血压患者动脉弹性功能.降压治疗1个月及6个月时,氨氯地平改善动脉弹性的作用更为明显.

Perindopril and Amlodipine Improve Arterial Stiffness in Patients with Hypertension

Aim To investigate the effect of perindopril and amlodipine on improving the artery stiffness in patients with hypertension.Methods Patients with primary hypertension were randomly assigned to perindopril(4 mg/d)and amlodipine(5 mg/d)regimen for 6 months(n=36 each).Brachial-ankle pulse wave velocity(BaPWV)was measured by an automatic brachial ankle pulse wave velocity device before treatment,after 1 month and 6 months of treatment.Results Systolic blood pressure(SBP),diastolic blood pressure(DBP)and pulse pressure(PP)were significantly decreased in two groups(P<0.01).There were no significant changes in heart rate(HR)in two groups(P>0.05).After 1 month of treatment,BaPWV was significantly decreased in perindopril(1 572.92±230.08 cm/s)and amlodipine group(1 542.31±227.59 cm/s)compared with those before treatment(1 737.39±275.99 cm/s and 1 765.50±294.57 cm/s,respectively)(P<0.001),which also occurred after 6 months of treatment(1 484.92±226.59 cm/s and 1 432.50±217.88 cm/s,respectively)(P<0.001).And BaPWV was significantly decreased after 6 months of treatment compared with 1 month treatment in two groups(P<0.001).The changes of BaPWV in one or six months were significantly greater in amlodipine group than in perindopril group(P<0.01).The change of BaPWV was significantly greater in six months than in one month in two grops(P<0.001).Conclusion Arterial stiffness of hypertensive patients was improved post amlodipine and perindopril therapy in proportion to therapy duration.Amlodipine is superior to perindopril on improving arterial stiffness of hypertensive patients.