苯磺酸左旋氨氯地平联合依那普利治疗老年单纯收缩期高血压的效果及对血管内皮细胞功能的影响探析

Effect of levamlodipine besylate combined with enalapril in the treatment of elderly patients with isolated systolic hypertension and their influence on the function of vascular endothelial cells

目的 探析老年单纯收缩期高血压患者应用苯磺酸左旋氨氯地平联合依那普利治疗的临床效果及对血管内皮细胞功能的影响。方法 100例老年单纯收缩期高血压患者,遵循随机数字表设计方式将其分为对照组、观察组,每组50例。对照组给予依那普利治疗,观察组给予依那普利联合苯磺酸左旋氨氯地平治疗。对比两组患者血压[日间平均收缩压(DMSBP)、夜间平均收缩压(NMSBP)、24 h平均收缩压(24 h MSBP)]水平、临床疗效、内皮功能指标[一氧化氮(NO)、血流介导的血管扩张功能(FMD)、内皮素-1(ET-1)]。结果 治疗前,两组患者DMSBP、NMSBP、24 h MSBP无显著差异(P>0.05);治疗后,两组DMSBP、NMSBP、24 h MSBP均较治疗前有所改善,其中观察组DMSBP(120.52±10.01)mm Hg(1 mm Hg=0.133 kPa)、NMSBP(113.74±11.81)mm Hg、24 h MSBP(117.54±10.87)mm Hg均低于对照组的(138.45±12.35)、(132.63±12.70)、(134.02±12.58)(P<0.05)。观察组病情控制总有效率96.0%显著高于对照组的80.0%(P<0.05)。治疗前,两组患者NO、FMD、ET-1水平无显著差异(P>0.05);治疗后,两组NO、FMD、ET-1水平均较治疗前有所改善,其中观察组NO(6.25±1.39)μmol/L、FMD(7.68±1.13)%高于对照组的(5.61±1.25)μmol/L、(5.31±1.01)%, ET-1(60.84±10.48)ng/L低于对照组的(68.15±9.59)ng/L(P<0.05)。结论 对老年单纯收缩期高血压患者给予苯磺酸左旋氨氯地平片联合依那普利治疗效果良好,可有效改善患者血压水平及内皮功能,可于此类患者群体中推广。

Objective To explore the clinical effect of levamlodipine besylate combined with enalapril in the treatment of elderly patients with isolated systolic hypertension and their influence on the function of vascular endothelial cells.Methods 100 cases of elderly patients with isolated systolic hypertension were divided into a control group and an observation group according to the design of random number table,with 50 cases in each group.The control group was treated with enalapril,and the observation group was treated with enalapril and levamlodipine besylate.The blood pressure[daytime mean systolic blood pressure(DMSBP),nighttime mean systolic blood pressure(NMSBP),24 h mean systolic blood pressure(24 h MSBP)],clinical efficacy,and endothelial function indexes[nitric oxide(NO),flow-mediated dilation(FMD),endothelin-1(ET-1)]of the two groups were compared.Results Before treatment,there were no significant differences in DMSBP,NMSBP and 24 h MSBP between the two groups(P>0.05).After treatment,DMSBP,NMSBP and 24 h MSBP in both groups were improved compared with those before treatment;the observation group had DMSBP of(120.52±10.01)mm Hg(1 mm Hg=0.133 kPa),NMSBP of(113.74±11.81)mm Hg and 24 h MSBP of(117.54±10.87)mm Hg,which were lower than(138.45±12.35),(132.63±12.70)and(134.02±12.58)mm Hg in the control group(P<0.05).The total effective rate of disease control in the observation group was 96.0%,which was significantly higher than 80.0%in the control group(P<0.05).Before treatment,NO,FMD and ET-1 levels were not significantly different between two groups(P>0.05).After treatment,the levels of NO,FMD and ET-1 in both groups were improved compared with those before treatment;the observation group had NO of(6.25±1.39)μmol/L and FMD of(7.68±1.13)%,which were higher than(5.61±1.25)μmol/L and(5.31±1.01)%in the control group;the observation group had lower ET-1 of(60.84±10.48)ng/L than(68.15±9.59)ng/L of the control group(P<0.05).Conclusion Levoamlodipine besylate tablets combined with enalapril has a good effect on elderly patients with isolated systolic hypertension,which can effectively improve blood pressure levels and endothelial function,and it can be popularized in this group of patients.