缓释型硝苯地平与氨氯地平的降压作用比较

Comparison of hypotensive effects with slow release formulation nifedipine and amlodipine

目的：比较缓释型硝苯地平与氨氯地平的动态降压作用。方法：１７例中、轻度原发性高血压病人（男性８例，女性９例，年龄４３±ｓ６ａ）８例予缓释型硝苯地平２０ｍｇ，ｐｏ，ｑｄ，９例予氨氯地平５～１０ｍｇ，ｐｏ，ｑｄ，×４ｗｋ。服药前、后做２４ｈ动态血压测定及踏车运动激发试验（ｎ＝１６）。结果：２药均有效地降低２４ｈ平均血压，但降压谷／峰（Ｔ／Ｐ）比值，收缩压（ＳＢＰ）Ｔ／Ｐ比值缓释硝苯地平组高于氨氯地平组，分别为８７％与７４％；舒张压（ＤＢＰ）Ｔ／Ｐ比值氨氯地平组高于缓释硝苯地平组，分别为８１％与６２％；运动激发下，服氨氯地平后ＤＢＰ仍能显著下降（Ｐ＜０．０１）及心率减慢（Ｐ＜０．０５）。结论：氨氯地平降２４ｈＤＢＰ的平稳性及对运动的耐受性均较缓释硝苯地平好。

AIM: To compare the ambulatory hypotensive effects of slow release formulation nifedipine and amlodipine. METHODS: Patients (M 8, F 9; age 43±s 6 a) with mild or middle degree essential hypertension divided into two groups and treated with slow release formulation of nifedipine 20 mg, po, qd each morning at 8 am×4 wk(n=8) and amlodipine 5-10 mg (average: 7.8 mg±2.6 mg), each morning at 8 am×4 wk(n=9). RESULTS: Both nifedipine and amlodipine lowered the 24 h average BP during ambulatory monitoring (P<0.05), but different trough: peak ratios for SBP and DBP were found (SBP: 87%, 74%, DBP: 62%, 81% respectively). The rises of DBP and heart rate during bicycle exercise test under amlodipine were less than those before amlodipine treated (P<0.01, P<0.05, respectively). CONCLUSION: It suggests that smooth profile of DBP during 24 h ambulatory monitoring and better tolerence for exercise exists in the patients with amlodipine than nifedipine.