西拉普利治疗高血压病临床效果观察

Effect of Cilazapril on Treatment of Essential Hypertension

目的：为了解西拉普利日服１次５ｍｇ，是否能使２４小时血压平稳下降。方法：将５５例高血压病患者随机分为西拉普利组３０例及卡托普利对照组２５例，均以２４小时动态血压监测。结果：西拉普利治疗前后昼夜平均血压分别由２１．７／１３．０ｋＰａ（１６３／９８ｍｍＨｇ）降至１８．０／１１．０ｋＰａ（１３６／８３ｍｍＨｇ），及由２２．０／１１．０ｋＰａ（１６５／８７ｍｍＨｇ）降至１７．６／１０．５ｋＰａ（１３１／７８ｍｍＨｇ）。而卡托普利组血压分别由２２．０／１２．８ｋＰａ（１６５／９６ｍｍＨｇ）降至１８．７／１１．８ｋＰａ（１４０／８８ｍｍＨｇ），及由２１．０／１１．０ｋＰａ（１６０／８６ｍｍＨｇ）降至１８．４／１０．０ｋＰａ（１３８／７５ｍｍＨｇ），（Ｐ＝０．２５）。西拉普利组治疗后，收缩压谷峰＝７１．０％，舒张压谷峰＝５２．０％，西拉普利组治疗前后收缩压及舒张压负荷率分别由９０．０％降至２６．７％（Ｐ＜０．００１），及由６７．７％降至１２．５％（Ｐ＜０．００１）。卡托普利分别由８９．８％降至２７．０％（Ｐ＜０．００１），及由６８．０％降至１３．５％（Ｐ＜０．００１）。结论：日服１次５ｍｇ西拉普利对高血压病有２４小时平稳?

Objective:To investigate if cilazapril 5 mg daily can control blood pressure 24 h steadily. Methods:Fifty five outpatients with essential hypertension were randomly divided into cilazapril group( n =30)and the captopril control group( n =25),the 24 h ambulatory pressure was monitored. Results:Cilazapril significantly reduced mean blood pressure from 21 7/13 0 kPa(163/98 mmHg)to 18 0/11 0 kPa(136/83 mmHg)during the day time and from 22 0/11 0 kPa(165/87 mmHg)to 17 6/10 5 kPa(131/78 mmHg)at night,while captopril reduced it from 22 0/12 8 kPa(165/96 mmHg)to 18 7/11 8 kPa(140/88 mmHg)and from 21 0/11 0 kPa(160/86 mmHg)to 18 4/10 0 kPa(138/75 mmHg),respectively.( p =0 25).In cilazapril treated patients the ratio of valley to peak of systolic blood pressure was 71 0%,and that of diastolic blood pressure was 52 0%;the load rates of systolic and diastolic blood pressure decreased from 90.0% to 26.7%( p <0 001)and from 67 7% to 12 5%( p <0 001),respectively.In captopril group,the respective load rates decreased from 89 8% to 27 0%( p <0 001)and from 68 0% to 13 5%( p <0 001). Conclusion:5 mg of cilazapril once a day can steadily control the blood pressure during 24 h in phases Ⅰ and Ⅱ essential hypertensives.