咪达普利与吲达帕胺联合治疗原发性高血压疗效及对内皮依赖性舒张功能的影响

Effects of combinated treatment with imidapril and indapamide on blood pressure and endothelial-dependent vasodilation function in essential hypertension

目的:探讨咪达普利与吲达帕联合治疗原发性高血压的临床疗效及对内皮依赖性舒张功能(FMD)的影响。方法:采用随机、平行、对照方法,307例高血压患者分3组:A组(61例)用吲哒帕胺2.5mg,qd;B组(118例)用吲哒帕胺2.5mg,qd,加美托洛尔25mg,bid;C组(128例)用吲哒帕胺2.5mg,qd加咪达普利5mg,qd。疗程均为8周。各组治疗2周后若偶测血压仍>140/90mmHg(1mmHg=0.133kPa)则药物剂量加倍(联合用药组吲哒帕胺剂量不变)。结果:3组高血压患者治疗8周后动态血压监测显示,除A组患者夜间平均收缩压(SBP)和平均舒张压(DBP)治疗前后差异无统计学意义外,其他动态血压指标均有明显改善(P<0·05)。心率除B组患者治疗后明显减低(P<0·01)外,其他2组治疗前后差异无统计学意义。治疗后组间血压各指标比较,B、C2组与A组均差异有统计学意义(P<0·05),而B组与C组之间均差异无统计学意义(P>0·05)。C组治疗后FMD有明显改善(P(0·01),而A、B2组治疗前后FMD无明显改变(P>0·05)。3组均未发现严重不良反应,A组有5例(8.2%)发生低钾血症,B组有3例(2.5%),C组未发现低钾血症;B组有8例(6.8%)出现心动过缓,A、C2组均未发现;C组有6例(4.7%)因干咳而退出试验,A、B2组均未发生。结论:咪达普利与吲达帕胺联合治疗高血压是一种较佳的组合,降压疗效较好,还具有改善内皮舒张功能的作用,不良反应少,且服用方便,价格便宜,可作为抗高血压药物联合治疗的优选方案。

Objective：To study the clinical effect of combinated treatment with imidapril and indapamide on blood pressure and endothelial-dependent vasodilation function in essential hypertension. Method： Three hundred and seven essential hypertension patients were enrolled randomly into A, B and C groups. Indapamide 2.5 to 5 mg qd were gived to A group for 8 weeks. Indapamide 2.5 mg qd combinated with metoprolol 25 to 50 mg bid were gived to B group for 8 weeks. Indapamide 2.5 mg combinated with imidapril 5 to 10 mg qd were gived to C group for 8 weeks. Result： No significant difference of night average SBP and DBP were found after 8 week treatment in A group,which the rest parameters in ABPM were improved significantly （ P〈0.05） after 8 week treatment . The average heart rate was decseased after 8 week treatment in B group, and no differences of the heart rate were found in A and C groups. The result of B and C groups was better than A group in decreasing BP after 8 week treatment （ P 〈[0. 05）. Otheswise, no difference was found between B group and C group. The FMD was improved significantly after 8 weeks treatment in C group （ P 〈0.01）. Condusion：Comhinated imidapril with indapamide is effective, safe, well tolerated and improves impaired endothelial dependent vasodilation function in essential hypertension.