贝尼地平对清晨高血压患者血压、左心室肥厚及UACR、baPWV的影响

Influence of benidipine on blood pressure, left ventricular hypertrophy, UACR and baPWV in patients with morning hypertension

目的:探究贝尼地平对清晨高血压患者血压、左心室肥厚及尿微量白蛋白与尿肌酐比值(UACR)、肱-踝脉搏波传导速度(baPWV)的影响。方法:选择我院心血管内科收治的原发性高血压患者142例,随机均分为贝尼地平组和氨氯地平组。两组患者在治疗前和治疗2个月后测量24 h动态血压,6个月后进行超声检查及微量白蛋白、尿肌酐、baPWV值测定,并计算UACR指数。结果:两组患者治疗后血压较治疗前均显著降低(P均=0.001),但两组治疗后血压比较差异无统计学意义(P均>0.05);治疗后,与氨氯地平组比较,贝尼地平组清晨血压总有效率(56.06%比74.24%)和白昼血压总有效率(62.12%比78.79%)显著提高(P均<0.05)。与治疗前比较,两组治疗后UACR值均显著降低(P均=0.001),超声心动图各指标及baPWV均无显著差异(P均>0.05);且治疗后,贝尼地平组UACR值较氨氯地平组降低更显著[(16.54±1.42)μg/mg比(18.25±1.53)μg/mg,P=0.001],两组间超声心动图各指标及baPWV值比较均无显著性差异(P均>0.05)。结论:贝尼地平和氨氯地平均能够有效控制血压水平,但贝尼地平较氨氯地平对高血压的总有效率,UACR的效果更加显著。

Objective: To explore influence of benidipine on blood pressure, left ventricular hypertrophy (LVH), urine microalbuminuria/creatinine ratio (UACR) and brachial-ankle pulse wave velocity (baPWV) in patients with morning hypertension (MH). Methods: A total of 142 patients with essential hypertension treated in our department were randomly and equally divided into benidipine group and amlodipine group. The 24h ambulatory blood pressure (24hABP) before and two months after treatment, ultrasonography, urine microalbumin (UMA) and creatinine (Ucr) and baPWV before and six months after treatment were measured in two groups, and UACR was calculated. Results: Compared with before treatment, there were significant reduction in blood pressure in two groups after treatment ( P =0.001 all), but there were no significant difference in blood pressure between two groups after treatment, P >0.05 all. Compared with amlodipine group after treatment, there were significant rise in total effective rates of MH (56.06% vs. 74.24%) and daytime blood pressure (62.12% vs. 78.79%) in benidipine group, P <0.05 both. Compared with before treatment, after treatment, there was significant reduction in UACR in two groups ( P =0.001 both), but there were no significant difference in UCG indexes and baPWV, P >0.05 all. Compared with amlodipine group after treatment, there was significant reduction in UACR [(18.25± 1.53)μg/mg vs.(16.54±1.42)μg/mg, P =0.001] in benidipine group, there were no significant difference in UCG indexes and baPWV between two groups, P >0.05 all. Conclusion: Both amlodipine and benidipine can effectively control blood pressure;and benidipine possesses more significant therapeutic effect on total effective rates and UACR.