三类降血压药物联合治疗皮质下动脉硬化性脑病方案的随机对照研究

Randomized and contrast study on the combined effects of three antihypertensive drugs in the patients with subcortical arteriosclerotic encephalopaphy

目的 :对比观察三类降血压迟效制剂和三类普通制剂联合应用对皮质下动脉硬化性脑病患者血压的影响。方法 :皮质下动脉硬化性脑病患者 6 6例 ,随机分为迟效制剂组 33例与普通制剂组 33例。分别口服迟效和普通剂型钙通道阻滞剂、β受体阻断剂和血管紧张素转换酶抑制剂 ,连续口服用药 10wk。动态观察患者心率、血压的变化。评估治疗前后病人日常生活活动独立程度。结果 :迟效制剂组与普通制剂组降压总有效率分别为 93.9%和87.9% (P >0 .0 5 )。迟效制剂对昼夜血压具有平稳的降压作用。不良反应发生率迟效制剂组和普通制剂组分别为 15 .2 %和 4 2 .4 % (P <0 .0 5 )。迟效制剂组不良反应多为轻度且一过性 ,对心率无明显影响。2组治疗后病人日常生活活动独立程度均无明显变化 (P >0 .0 5 )。结论 :降血压迟效制剂治疗皮质下动脉硬化性脑病的疗效好 。

AIM: To compare the effects of three types of antihypertensive drugs of delayed action preparation (DAP) and three types of typical preparation (TP) on the blood pressure of patients with subcortical arteriosclerotic encephalopaphy. METHODS: Sixty six patients with subcortical arteriosclerotic encephalopaphy were randomly divided into DAP group and TP group, each group including 33 patients. Three types of antihypertensive drugs of DAP and TP, including calcium antagonist, β receptor blocker and angiotensin converting enzyme inhibitor, were used orally in respective group for ten consecutive weeks. Blood pressure and heart rate were monitored dynamically. Activities of daily living (ADL) of each patient were investigated before and after treatment. RESULTS: Total effective rates of antihypertension were 93.9% and 87.9% in DAP group and in TP group, respectively (P> 0.05 ). The effects of DAP were found to be stable in day time and at night. The rates of side effects were 15.2% and 42.4% (P< 0.05 ) in DAP group and TP group, respectively. Most side effects were mild and transient in DAP group, without significant effect on the heart rate. There was not significant change on ADL scores in both groups after the treatment (P> 0.05 ). CONCLUSION: Antihypertensive drugs of ADP are effective agents with a good tolerance in treatment of hypertensive patients with subcortical arteriosclerotic encephalopathy.