缬沙坦联合氨氯地平对高血压患者血压变异性与血浆NPY及NT水平的影响

Effects of valsartan and amlodipine on blood pressure variability and the plasma neuropeptide Y and neurotensin in patients with essential hypertension

目的探讨缬沙坦联合氨氯地平对高血压患者血压变异性(BPV)与血浆神经肽Y(NPY)及神经降压素(NT)水平的影响。方法选择2015年6月至2016年12月重钢总医院住院部及门诊原发性高血压患者76例,根据随机数字表法分为对照组与研究组,各38例。对照组给予缬沙坦治疗,研究组给予缬沙坦联合氨氯地平治疗,2组均连续治疗3个月。2组在治疗前后均进行24 h动态血压监测,同时检测血浆NPY及NT水平。结果研究组治疗后24 h收缩压(24 hSBP)、24 h舒张压(24 hDBP)、24 h收缩压变异(24 hSBPV)、24 h舒张压变异(24 hDBPV)明显低于对照组,差异均有统计学意义(P<0.05);研究组治疗后血浆NPY水平低于对照组,血浆NT水平高于对照组,差异均有统计学意义(P<0.05)。结论缬沙坦联合氨氯地平治疗高血压,可降低24 hSBP、24 hDBP、24 hSBPV、24 hDBPV,同时能调节血浆NPY及NT水平,NPY及NT可能参与了血压变异的发病机制。

Objective To investigate the effects of valsartan and amlodipine on blood pressure variability(BPV)and the plasma neuropeptide Y(NPY)and neurotensin(NT)in patients with essential hypertension.Methods A total of 76 patients with essential hypertension in inpatient department and outpatient department of General Hospital of Chonggang from June 2015 to December 2016 were selected as the research objects,who were divided into control group(n=38)and study group(n=38)according to the stochastic digital table method.Valsartan was treated in the control group,valsartan combined with amlodipine was treated in the study group,two groups were treated continuously for 3 months.24-hour ambulatory blood pressure monitoring and the levels of plasma NPY and NT were performed before and after treatment in both group.Results The 24-hour systolic blood pressure(24 hSBP),24-hour diastolic blood pressure(24 hDBP),24-hour systolic blood pressure variability(24 hSBPV),24-hour diastolic blood pressure variability(24 hDBPV)in the study group after treatment were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The plasma NPY level in the study group after treatment was significantly lower than that in the control group,the plasma NT level in the study group was significantly higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion Valsartan combined with amlodipine in the treatment of patients with essential hypertension can significantly decrease 24 hSBP,24 hDBP,24 hSBPV,24 hDBPV,while regulate the level of plasma NPY and NT,NPY and NT may be involved in the pathogenesis of blood pressure variability.