西地那非治疗顽固性高血压患者疗效观察

Clinical observation of sildenafil in patients with resistant hypertension

目的观察枸橼酸西地那非对顽固性高血压患者的临床疗效。方法选取2013年1月至2016年10月海南医学院附属第二医院顽固性高血压住院患者52例为观察对象,采用随机、单盲、安慰剂对照的方法分为西地那非组和安慰剂组各26例,所有患者治疗8周,通过治疗前、后24 h动态血压变化评价西地那非对于顽固性高血压的疗效。结果经过8周治疗,西地那非组患者24 h平均动脉压的降幅明显优于安慰剂组[收缩压(SBP)(-8.8±1.4)mmHg vs(1.3±1.2)mmHg;舒张压(DBP)(-5.3±3.3)mmHg vs(1.8±1.1)mmHg;平均动脉压(MBP)(-7.9±3.6)mmHg vs(0.8±0.9)mmHg],血压降幅在白昼更加明显[SBP(-6.0±4.7)mmHg vs(4.4±1.5)mmHg;DBP(-4.6±4.1)mmHg vs(0.92±2.2)mmHg;MBP(-4.8±3.9)mmHg vs(3.5±1.4)mmHg],差异均有统计学意义(P<0.05)。夜间血压两组患者差异无统计学意义(P>0.05)。结论西地那非可用于顽固性高血压患者的治疗。

Objective To observe clinical effect of the sildenafil in patients with resistant hypertension. Methods A randomized, single-blinded, placebo-controlled clinical trial was adopted to divide 52 patients with resis- tant hypertension in Second Hospital Affiliated to Hainan Medical College from January 2013 to Oct 2016 into sildena- fil group （n=26） and placebo group （n=26）. The treatment course of all the patients was 8 weeks. The 24-hour ambula- tory blood pressure changes before and after treatment were observed to evaluate the effect of sildenafil on resistant hy- pertension. Results After 8-week treatment, the reduction of 24-hour mean blood pressure of the patients in the silde- nafil group was significantly better than that in placebo group, systolic blood pressure （SBP） （-8.8± 1.4） mmHg vs （1.3± 1.2） mmHg, diastolic blood pressure （DBP） （-5.3±3.3） mmHg vs （1.8±1.1） mmHg, mean blood pressure （MBP） （-7.9±3.6） mmHg vs （0.8±0.9） mmHg. The daytime mean blood pressure of the patients in the sildenafil group was significant- ly better than that in placebo group, which were SBP （-6.0±4.7） mmHg vs （4.4±1.5） mmHg, DBP （-4.6±4.1） mmHg vs （0.92±2.2） mmHg, MBP （-4.8±3.9） mmHg vs （3.5±1.4） mmHg, showing the statistical differences （P〈0.05）. No statisti- cal difference in the nighttime mean blood pressure was found （P〉0.05）. Conclusion Sildenafil can effectively re- duce the artery blood pressure in patients with resistant hypertension.