硝苯地平联合贝那普利治疗老年高血压的临床研究

目的探讨硝苯地平联合贝那普利治疗老年高血压的临床疗效。方法选取2015年4月—2015年12月在天津市河西区康复医院就诊的老年高血压患者86例,随机分为对照组和治疗组,每组各43例。对照组患者口服盐酸贝那普利片,10 mg/次,1次/d,根据血压情况剂量加至20~40 mg/d。治疗组患者在对照组的基础上口服硝苯地平控释片,30 mg/次,1次/d。两组患者均连续治疗6周。观察并比较两组患者临床疗效、内皮舒张功能、内皮分泌功能和动脉血压变化。结果治疗后,对照组的总有效率为79.07%,显著低于治疗组的93.02%,两组总有效率比较差异有统计学意义(P0.05)。治疗后,两组患者24 h平均舒张压(24 h DBP)、24 h平均收缩压(24 h SBP)、白天平均舒张压(d DBP)、白天平均收缩压(d SBP)、晚上平均舒张压(n DBP)、晚上平均收缩压(n SBP)和收缩压的昼夜变异率(BPF)均显著下降(P0.05);且治疗组患者动脉血压改善优于对照组(P0.05)。治疗后,两组患者肱动脉内径变化率(FMD)均显著升高(P0.05);且治疗后治疗组患者FMD显著高于对照组(P0.05)。治疗后,两组患者血清NO水平显著上升,内皮素(ET)和神经肽Y(NPY)水平显著下降,同组比较差异具有统计学意义(P0.05);且治疗组患者NO、ET和NPY水平显著优于对照组,两组比较差异具有统计学意义(P0.05)。结论硝苯地平控释片联合贝那普利治疗老年高血压,可以降低血压变异性,改善血管内皮功能,具有一定的临床推广应用价值。

Clinical study on nifedipine combined with benazepril in treatment of elderly hypertension

Objective To investigate the clinical effect of nifedipine combined with benazepril in treatment of elderly hypertension. Methods Patients (86 cases) with hypertension in Rehabilitation Hospital of Hexi District in Tianjin City from April 2015 to December 2015 were randomly divided into control and treatment groups, each group had 43 cases. Patients in the control group were poadministered with Benazepril Hydrochloride Tablets, 10 mg/time, once daily, and the dosage was increased to 20 — 40 mg/d according to blood pressure conditions. Patients in the treatment group were poadministered with Nifedipine Controlled-release Tablets on the basis of the control group, 30 mg/time once daily. Patients in two groups were treated for six weeks. After treatment, the clinical efficacy, endothelial dilation function, endothelial secretion function, and arterial blood pressure change in two groups before and after treatment were observed and compared.Results After treatment, the clinical efficacy in the control group was 79.07%, which was significantly lower than 93.02% in the treatment group, with significant difference between two groups (P < 0.05). After treatment, the 24 h SBP, dSBP, nSBP, 24 h DBP, dDBP, nDBP, and BPF in two groups significantly decreased (P < 0.05). And the arterial blood pressure change in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the FMD in two groups significantly increased (P < 0.05). And FMD in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the serum NO level in two groups significantly increased, ET and NPY levels significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the NO, ET, and NPY levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05).Conclusion Nifedipine combined with benazepril can decrease blood pressure variability and improve vascular endothelial function in treatment of elderly hypertension, which has a certain clinical application value.