硝苯地平联合贝那普利治疗老年高血压效果观察

Effects of nifedipine combined with benazepril on cardiovascular and renal function in elderly patients with hypertension

目的高血压常发于老年人群,会对患者心肾等器官造成损害。本研究探究硝苯地平联合贝那普利对老年高血压患者心血管功能和肾功能的影响。方法选取2016-03-01-2018-04-30漯河市郾城区人民医院收治的88例老年高血压患者为研究对象,按照组间性别、年龄和病程等因素均衡的原则分为观察组和对照组,各44例。对照组采用贝那普利治疗,观察组采用硝苯地平联合贝那普利治疗。治疗12周结束时,比较两组治疗前后收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、心率、心血管功能指标[血管内径变化率(flow-mediated diameter,FMD)与血清内皮素(endothelin,ET)、神经肽Y(neuropeptide Y,NPY)、一氧化氮(nitric oxide,NO)]与肾功能指标[尿微量白蛋白(micro-albumin urine,MAU)、β2-微球蛋白(β2-microglobulin,β2-MG)、血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,SCr)]水平及治疗期间不良反应状况。结果治疗12周结束后,观察组SBP、DBP和心率分别为(124.05±8.56)mm Hg、(75.18±7.18)mm Hg和(60.08±4.41)次/min,低于对照组的(138.15±8.42)mm Hg、(86.03±8.95)mm Hg和(70.24±4.65)次/min,差异有统计学意义,t值分别为7.790、6.273和12.752,均P<0.001;观察组FMD和NO水平分别为(6.25±1.56)和(57.08±9.34)μmol/L,高于对照组的(5.15±1.42)和(50.92±9.25)μmol/L,t值分别为3.459和3.108,P值分别为0.001和0.003;ET和NPY水平分别为(50.18±10.18)ng/L和(182.08±15.41)pg/mL,低于对照组的(58.03±10.95)ng/L和(188.24±19.65)pg/mL,差异有统计学意义,t值分别为3.483和2.168,P值分别为0.001和0.033;观察组MAU(t=2.292,P=0.024)、β2-MG(t=9.101,P<0.001)、BUN(t=2.068,P=0.042)和SCr(t=6.129,P<0.001)水平低于对照组,差异有统计学意义。治疗期间,观察组不良反应发生率为13.64%,与对照组的11.36%比较,差异无统计学意义,χ^2=0.104,P=0.747。结论硝苯地平联合贝那普利治疗老年高血压临床效果显著,能有效降低血压与心率,改善心血管功能和肾功能,且安全性较高。

OBJECTIVE Hypertension often occurs in the elderly,which can cause damage to heart and kidney and other organs.This study was designed to investigate the effects of nifedipine combined with benazepril on cardiovascular and renal functions in elderly patients with hypertension.METHODS A total of 88 elderly patients with hypertension admitted to the People′s Hospital of Naocheng District of Luohe City from March 1,2016 to April 30,2018 were selected as the study subjects.They were divided into observation group and control group according to the principle of gender,age and course of disease.The control group was treated with benazepril,while the observation group was treated with nifedipine combined with benazepril.At the end of 12weeks,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate and cardiovascular function indexes[flow-mediated diameter(FMD),serum endothelin(ET),neuropeptide Y(NP)]were compared between the two groups before and after treatment.Renal function indicators[micro albumin urine(MAU),β2-microglobulin(β2-MG),blood urea nitrogen(BUN),serum creatinine(SCr)]levels and adverse reactions during treatment were compared.RESULTS After 12 weeks of treatment,the SBP,DBP and HR of the observation group were(124.05±8.56)mm Hg,(75.18±7.18)mm Hg and(60.08±4.41)times/min,respectively,lower than those of the control group(138.15±8.42)mm Hg,(86.03±8.95)mm Hg and(70.24±4.65)times/min,and the t values were 7.790,6.273 and 12.75,respectively,all P<0.001;FMD and NO levels in the observation group were(6.25±1.56)and(57.08±9.34)μmol/L,respectively,higher than those in the control group(5.15±1.42)and(50.92±9.25)μmol/L,t values were 3.459 and 3.108,Pvalues were 0.001and 0.003,while ET and NPY levels were(50.18±10.18)ng/L and(182.08±15.41)pg/ml,lower than those in the control group(58.03±10.95)ng/L and(188.24±19.65)pg/ml,t values were 3.483 and 2.168,Pvalues were 0.001 and 0.033.The levels of MAU(t=2.292,P=0.024),β2-MG(t=9.101,P<0.001),BUN(t=2.068,P=0.042)and SCR(t=6.129,P<0.001)in the observation group were lower than those in the control group.There was significant difference between the control group and the control group.During the treatment period,the incidence of adverse reactions was 13.64% in the observation group and 11.36% in the control group.There was no significant difference,χ^2=0.104,P=0.747.CONCLUSION Nifedipine combined with benazepril in the treatment of elderly hypertension has significant clinical effect,can effectively reduce blood pressure and heart rate,improve cardiovascular and renal functions,and has high safety.