血脂康胶囊联合降压药治疗对动脉顺应性及动态血压平滑性的影响

Effects of Combined Application of Xuezhikang Capsule with Hypotensive Drugs on Arterial Compliance and Smoothness of the Dynamic Blood Pressure

目的观察血脂康胶囊联合降压药治疗对高血压病患者24h动态血压(24hPP)、脉压指数(pulse pressure index,PPI)、脉搏波传导速度(pulse wave velocity,PWV)及血压平滑指数(smoothness index,SI)的影响,并研究年龄、血压、动态脉压指数、血管弹性等与血压平滑指数的相关性。方法 110例原发性高血压患者随机分为单纯降压组(对照组,54例)和调脂降压治疗组(治疗组,56例),对照组单纯应用降压药物,治疗组在降压基础上加用血脂康胶囊600mg,每天2次。所有患者均于治疗前及治疗6个月后行PWV及动态血压检查,记录24h平均收缩压(24hSBP)及24h平均舒张压(24hDBP),计算24hpp、PPI和收缩及舒张压平滑指数(SISBP、SIDBP),比较两组患者治疗前后PWV、动态血压值及其稳定性的变化,并分析治疗后影响SI的相关因素。结果两组血压控制良好,6个月后治疗组24hPP、PPI[(45±8)mmHg、(0.35±0.08)]明显低于对照组[(51±10)mmHg、(0.38±0.05)],差异有统计学意义(P<0.05),治疗组SI(SISBP:1.37±0.16、SIDBP:1.28±0.14)较对照组(SISBP1.26±0.20、SIDBP1.18±0.23)升高(SISBP:P<0.01,SIDBP:P<0.05),治疗组PWV(10.4±3.68)m/s明显低于对照组(12.5±4.27)m/s,P<0.05。多元逐步回归分析显示,年龄、PPI、PWV与SISBP呈显著负相关(P<0.01),SIDBP与PPI呈显著负相关(P<0.01)。结论降压药治疗协同血脂康降脂治疗能降低动态血压的PP和PPI,改善内皮功能及动脉弹性,并且能提高降压药物对SI的疗效,治疗后SI与PPI、PWV和年龄具有明显负相关性。

Objective To investigate the effects of combined application of Xuezhikang Capsule （XZK） and hypotensive drugs on the dynamic blood pressure （DBP）, pulse pressure index （PPI）, pulse wave velocity （PWV） and smoothness index （SI）, and to study the relationship between SI and related factors （age, BP, dynamic PPI, and vascular elasticity）. Methods One hundred and ten patients with essential hypertension were randomly assigned to 2 groups： 54 in the control group and 56 in the treated group. Both were treated with hypertensive drugs, but with oral medication of XZK given additionally to the treated group at the dose of 60 mg, twice a day. PWV and DBP were measured before treatment and at the terminal of a 6-month treatment. Meantime, the 24-h average systolic and diastolic pressures were recorded to calculate the 24-h dynamic pulse pressure （24 hPP）, PPI, SI of systolic and diastolic blood pressure （SISBP and SIDBP） for comparing the changes between groups and analyzing the SI related factors. Results All patients′ blood pressure levels were well controlled; after a 6-month treatment, the PP and PPI in the treated group were 45±8 mm Hg and 0.35±0.08 respectively, which were significantly lower than those in the control group （51±10 mm Hg and 0.38±0.05, P0.05）; while SISBP and SIDBP in the treated group were higher than those in the control group （1.37±0.16 vs 1.26±0.20, P0.01; and 1.28±0.14 vs 1.18±0.23, P0.05） respectively; and PWV in the former was significantly lower than that in the latter group （10.4±3.68 m/s vs 12.5±4.27 m/s, P0.05）. Multiple factor stepwise regression analysis showed that the SISBP was negatively correlated with age, PPI and PWV, while the SIDBP was negatively correlated with PPI （P0.01）. Conclusion The combined application of XZK and hypotensive drugs can decrease PP and PPI, improve the endothelial function and arterial elasticity, enhance the efficacy of treatment on SI.After treatment SI shows a significant negative correlation with PPI, PWV and age in patients.