抑平舒的降压效果和对睡眠呼吸障碍的影响

Antihypertensive Efficacy and Effect on Sleep Apnea Syndrome \;by Cilazapril

目的：本文探讨血管紧张素转换酶抑制剂（ＡＣＥＩ）抑平舒（Ｃｉｌａｚａｐｒｉｌ）的降压效果和对睡眠呼吸暂停综合症（ＳＡＳ）的影响。方法：门诊可疑合并有睡眠呼吸暂停综合症（ＳＡＳ）的２７ 例高血压（ＨＴ）患者，在停服各种血管活性药２ 周后，口服抑平舒２．５～５ ｍ ｇ，并于治疗前后分别同时接受２４ 小时动态血压（ＡＢＰ）监测和多导睡眠仪（ＰＳＧ）检查。结果：服药４周后，２７ 例高血压患者诊室血压和２４ 小时动态血压明显下降，而心率无显著变化。其中，１６ 例高血压合并睡眠呼吸暂停综合征的患者，治疗后呼吸紊乱指数（ＡＨＩ）由３０．５±２０．４ 降到２３．５±１９．９（Ｐ＜ ０．０５），睡眠结构无明显变化，未见明显的副作用。结论：对高血压合并睡眠呼吸暂停综合征的患者，血管紧张素转换酶抑制剂抑平舒（Ｃｉｌａｚａｐｒｉｌ），能有效地降低２４ 小时血压，尤其对夜间高血压有较好的效果，同时减少呼吸紊乱指数。

Purpose: To investigate the antihypertensive efficacy and the effect on sleep apnea syndrome(SAS) by ACE inhibitor cilazapril. Method: Twenty seven hypertension patients with predisposing factors in SAS were followed by a 4 weeks cilazapril 2.5～5 mg once daily. 24 h ambulatory blood pressure(ABP) monitoring and polysomnography(PSG) were carried out before and after treatment. Result: Blood pressure and Apnea/Hypopnes Index(AHI) were reduced significantly (38.5±20.4 to 23.5±19.9, P <0.05) in 16 patients complicated with SAS and heart rate has no change. Conclusion: In the patients with HT and SAS, the ACE inhibitor cilazapril can decrease blood pressure and decrease AHI with well tolerated.