左旋氨氯地平、阿替洛尔用于伴颈动脉粥样硬化的高血压患者的疗效评估

A Study to Assess Effects of L-amlodipine versus Atenolol in Hypertensive Patients with Carotid Atherosclerosis

目的评估左旋氨氯地平、阿替洛尔用于伴颈动脉粥样硬化的高血压患者。方法将168例1～2级高血压合并颈动脉粥样硬化患者随机分为治疗组与对照组：治疗组给予左旋氨氯地平,对照组给予阿替洛尔。在治疗前及治疗后3、12个月时,分别测定各组的血压、超敏C反应蛋白（hs-CRP）及行颈部血管超声检查颈动脉内中膜厚度、斑块最大厚度、斑块最大长度。结果 1治疗组、对照组在治疗后3、12个月,平均收缩压、平均舒张压及超敏反应蛋白与治疗前相比均有所下降,差异有统计学意义（P〈0.05）;22组治疗后3个月,颈动脉内中膜厚度（IMT）、斑块最大厚度（Tmax）、斑块最大长度（Lmax）与治疗前相比无明显变化,差异无统计学意义（P〉0.05）;在治疗后1年,与治疗前相比颈动脉粥样硬化各项指标进行性减小,差异均有统计学意义（P〈0.05）;3组间比较,治疗后3、12个月,2组平均收缩压下降幅度、平均舒张压下降幅度、hs-CRP减小幅度及颈动脉粥样硬化各指标减小幅度,同期组间比较均无统计学差异（P〉0.05）。结论左旋氨氯地平有良好的降血压作用,并且具有一定的抗动脉粥样硬化作用,可用于伴颈动脉粥样硬化的高血压患者。

OBJECTIVE To assess the effects of L-amlodipine versus atenolol in hypertensive patients with carotid atherosclerosis. METHODS A total of 168 patients with grade 1-2 hypertension with carotid atherosclerosis were randomly assigned to treatment group（ L-amlodipine） or control group（ atenolol）. Blood pressure（ BP）,hypersensitive c-reactive protein（ hs-CRP）,intima-media thickness（ IMT）,plaque thickness（ Tmax）,and plaque maximum length（ Lmax） were measured before treatment and at 3months,12 months after the treatment,respectively. RESULTS 1The average systolic pressure,average diastolic pressure and hsCRP were decreased in patients of both groups after 3 months,12 months treatments,and compare with before treatment,respectively,and the results showed significant difference in both groups（ P 〈0. 05）. 2 In both groups,IMT,Tmax,Lmaxcompared with before treatment showed no obvious change after 3 months of treatment,the difference had no statistically significance（ P 〉0. 05）. But all indexes that carotid atherosclerosis-related decreased after 1 year treatment,and the results showed significant difference between the 2groups（ P〈 0. 05）. 3After 3 and 12 months treatment,the decreased of average systolic and diastolic blood pressure,decreased of hsCRP,and all carotid artery atherosclerosis-related indexes decreased amplitude showed no differences between the 2 groups（ P 〉0.05）. CONCLUSION L-amlodipine has good blood pressure lowering effect,and has certain anti-atherosclerotic effect,it can be used in the treatment of hypertensive patients with carotid atherosclerosis