两种钙离子拮抗剂治疗老年非杓型高血压临床对比研究

Clinical Comparative Research on Two Calcium Antagonists in Treatment of Elderly Non-dipping Hypertension

目的探讨硝苯地平和氨氯地平治疗老年非杓型高血压临床疗效及安全性差异。方法研究对象整群选取该院2013年3月—2015年6月收治老年非杓型高血压患者共170例,以随机数字表法分为A组(85例)和B组(85例),分别采用氨氯地平与硝苯地平治疗;比较两组患者诊室血压控制率,血压昼夜节律异常改善率及不良反应发生率等。结果 A组患者诊室血压控制率分别为81.54%(53/85),84.62%(55/85);两组患者血压控制率比较差异无统计学意义(P>0.05);A组和B组患者血压昼夜节律异常改善率分别为31.76%(27/85),54.12%(46/85);B组患者血压昼夜节律异常改善率显著高于A组(P<0.05);A组患者中发生头晕3例,头痛2例,面色潮红8例,不良反应发生率为15.29%;B组患者中发生头晕4例,头痛4例,面色潮红7例,不良反应发生率为17.65%;两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论硝苯地平和氨氯地平治疗老年非杓型高血压均可有效控制血压水平,并未导致严重不良反应发生;但硝苯地平应用在促进血压昼夜节律恢复方面效果优于氨氯地平。

Objective To discuss the differences in the clinical curative effect and safety of nifedipine and amlodipine in treatment of elderly non-dipping hypertension. Methods 170 cases of elderly patients with non-dipping hypertension admitted and treated in our hospital from March 2013 to June 2015 were selected as the research objects and randomly divided into two groups with 85 cases in each, the group A were treated with amlodipine, the group B were treated with nifedipine, and the office blood pressure control rate, circadian blood pressure profile abnormal improvement rate and incidence rate of adverse reactions were compared between the two groups. Results The difference in the office blood pressure control rate between the group A and the group B had no statistical significance, [81.54%（53/85） vs 84.62%（55/85）],（P〈0.05）; the circadian blood pressure profile abnormal improvement rate in the group B was obviously higher than that in the group A[（31.76%（27/85） vs 54.12%（46/85）],（P〉0.05）; in the group A, dizzy occurred to 3 cases, headache occurred to 2 cases,flushed face occurred to 8 cases and the incidence rate of adverse reactions was 15.29%, in the group B, dizzy occurred to4 cases, headache occurred to 4 cases, flushed face occurred to 7 cases and the incidence rate of adverse reactions was17.65%, and the difference in the incidence rate of adverse reactions between the two groups had no statistical significance by comparison（P〉0.05）. Conclusion Nifedipine and amlodipine in treatment of elderly non-dipping hypertension can effectively control the blood pressure level and cannot lead to adverse reactions, but the effect of nifedipine in promoting the recovery of circadian blood pressure profile is better than that of amlodipine.