氨氯地平对单纯收缩期高血压患者的降压效果及对血管内皮细胞功能的影响

Effect of Amlodipine on Blood Pressure and Vascular Endothelial Cell Function in Patients with Isolated Systolic Hypertension

目的:分析氨氯地平对单纯收缩期高血压患者的降压效果及对血管内皮细胞功能的影响。方法:选择2016年10月至2017年12月于我院接受治疗的92例单纯收缩期高血压患者,按简单随机数字表法分为对照组和观察组,每组46例。对照组予以依那普利治疗,观察组予以氨氯地平治疗。比较两组临床疗效、血压改变、血管内皮细胞功能及不良反应发生情况。结果:观察组总有效率显著高于对照组,比较有统计学差异(P <0.05)。治疗前,两组白昼平均收缩压(dSBP)、夜间平均收缩压(n SBP)、24h平均收缩压(24SBP)比较差异无统计学意义(P> 0.05);治疗后4周、6周两组d SBP、nSBP、24hSBP均降低,观察组下降更明显,比较有统计学差异(P <0.05)。治疗前,两组一氧化氮(NO)、内皮素-1(ET-1)、肱动脉血流介导的血管舒张功能(FMD)比较差异无统计学意义(P>0.05);治疗后4周、6周,两组NO及FMD均上升,ET-1均下降,观察组变化更明显,两组组间、不同时点间比较有统计学差异(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:氨氯地平对单纯收缩期高血压患者的降压效果较好,能够改善血管内皮细胞功能,可为临床降压方案提供参考。

Objective： To analyze the antihypertensive effect of amlodipine in treatment isolated systolichypertension and its influences on endothelial cell function. Methods： 92 patients with isolated systolic hypertension who were treated from October 2016 to December 2017 in our hospital were divided into the control group （treated with enalapril） and observation group （ treated with amlodipine） according to the simple random number table method with 46 cases in each group. The clinical efficacy, blood pressure changes, vascularendothelial cell function, and adverse reactions in both group were compared. Results： Total effective rate inthe observation group was significantly higher than the control group, there was statistical differences （P 〈0.05）. Before treatment, daytime systolic blood pressure （ dSBP）, average nighttime systolic blood pressure（nSBP） and 24h average systolic blood pressure （24SBP） in both groups were not statistically significant （P〉0.05）. After treatment of 4 weeks and 6 weeks, dSBP,nSBP,24hSBP in both group were declined, whilethe observation group decreased more obviously. There was statistically significant differences（P 〈0.05）. Before treatment, the nitric oxide （NO）, endothelin-1 （ET-1） and brachial artery flow-mediated vasodilation（FMD） in both groups were no differences. But after treatment of 4 weeks and 6 weeks, NO and FMD in bothgroups were all rised, ET-1 was decreased, while the observation group changed was more obvious. There wasstatistically significant differences （P〈0.05）. Adverse reaction rate in both groups were not statistically significant （P〉0.05）. Conclusion： Antihypertensive effect is better of amlodipine in treatment isolated systolic hypertension, and it can improve the function of vascular endothelial cells, which can provide reference for clinical blood pressure reduction.