氨氯地平联合缬沙坦对老年高血压患者内皮素-1、一氧化氮及血管弹性功能的影响
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摘要
目的观察氨氯地平联合缬沙坦对老年高血压患者内皮素-1(ET—1)、一氧化氮(NO)及血管弹性功能的影响。方法 老年高血压患者40例随机分为2组,每组20例。观察组给予氨氯地平与缬沙坦联合治疗,对照组仅给予缬沙坦治疗,比较2组血压、ET-1、NO以及血管弹性功能指标变化。结果 2组治疗2、4、6、8周后,血压均较治疗前下降,且观察组下降较对照组更明显(P均<0.05);与治疗前比较,2组治疗8周后ET-1、NO均改善(P<0.05),且观察组改善较对照组明显(P<0.05);2组治疗8周后,大动脉弹性指数(C_1)、小动脉弹性指数(C_2)均较治疗前增高,且观察组较对照组增高明显(P<0.05);治疗8周后,2组脉搏波传导速度(PWV)及踝臂指数均优于治疗前,且观察组优于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 氨氯地平联合缬沙坦治疗老年高血压患者降压效果明显,ET-1均明显下降,NO明显升高,血管弹性功能改善。
Objective To observe the effect of amlodipine combined with valsartan on the blood pressure,endothelin(ET-1) and NO in elderly patients with hypertension.Methods Forty cases of elderly patients with hypertension were randomly divided into two groups of 20 cases in each group.Observation group were given amlodipine and valsartan combination therapy,the control group only received valsartan,compared two groups' blood pressure,ET-1,NO and vascular elasticity index changes.ResuItB Two groups 2,4,6,8 weeks after treatment,compared with pre-treatment,blood pressure were dropped,and the observation group decreased more signiiicandy than in the control group(P < 0.05);compared with before treatment,2 groups after 8 weeks of treatment,ET-1,NO were improved(P <0.05),and observation group significandy improved compared with the control group(P <0.05);in both groups after 8 weeks of treatment,arterial elastic index(C_1,C_2)increased than those before treatment,and observation group significandy higher than the control group(P <0.05);after 8weeks of treatment,in two groups pulse ware velocity(PWV) and ankle-brachial index were better than those pre-treatment,observation group was better than control group(P <0.05).2 groups' incidence of adverse reactions was showed no significant difference(P >0.05).Conclusion It's demonstrated that the amlodipine combined with valsartan had good efficacy in elderly hypertensive patients the antihypertensive effect is obvious,ET-1 were significandy decreased,NO were significandy increased,vascular elastic function were improved.
Objective To observe the effect of amlodipine combined with valsartan on the blood pressure,endothelin(ET-1) and NO in elderly patients with hypertension.Methods Forty cases of elderly patients with hypertension were randomly divided into two groups of 20 cases in each group.Observation group were given amlodipine and valsartan combination therapy,the control group only received valsartan,compared two groups' blood pressure,ET-1,NO and vascular elasticity index changes.ResuItB Two groups 2,4,6,8 weeks after treatment,compared with pre-treatment,blood pressure were dropped,and the observation group decreased more signiiicandy than in the control group(P < 0.05);compared with before treatment,2 groups after 8 weeks of treatment,ET-1,NO were improved(P <0.05),and observation group significandy improved compared with the control group(P <0.05);in both groups after 8 weeks of treatment,arterial elastic index(C_1,C_2)increased than those before treatment,and observation group significandy higher than the control group(P <0.05);after 8weeks of treatment,in two groups pulse ware velocity(PWV) and ankle-brachial index were better than those pre-treatment,observation group was better than control group(P <0.05).2 groups' incidence of adverse reactions was showed no significant difference(P >0.05).Conclusion It's demonstrated that the amlodipine combined with valsartan had good efficacy in elderly hypertensive patients the antihypertensive effect is obvious,ET-1 were significandy decreased,NO were significandy increased,vascular elastic function were improved.
引文
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13于建敏,陈晓星,何云.缬沙坦联合氨氯地平治疗糖尿病合并高血压病效果观察[J].临床误诊误治,2009,22(6):1-3.
14魏宇淼,程龙献.高血压的治疗进展:新药物、新技术与血压管理[J].临床心血管病杂志,2013,29(10):723-725.
15杨松,蒋颖,吴坚.缺血性脑卒中患者胱抑索c与颈动脉粥样硬化的关系[J].中华老年心脑血管病杂志,2013,15(10):1021-1023.
16杨静,李世平,李震中.尼莫地平注射液对脑出血急性期患者高血压调控的体会[J].脑与神经疾病杂志,2013.21(3):224-226.
17贾荣波,刘永选,王兆红.高血压患者强化管理与常规管理的比较研究[J].中国循环杂志,2013,28(5):360-363.
18刘华.厄贝沙坦联合硝苯地平对高血压患者心功能改善影响研究[J].北方药学,2013,10(10):36-37.
2刘洪军,张跃国,李佳.缬沙坦联合氨氯地平治疗原发性高血压的疗效观察[J].中国现代医生,2013,51(8):48-49.
3刘维旭,遇俊清,张建国.缬沙坦联合苯磺酸左旋氨氯地平治疗高血压肾病疗效观察[J].疑难病杂志,2013,12(6):462-463.
4周宗宝.高血压联合用药185例疗效观察[J].海南医学,2013,24(18):2714-2715.
5卿平,李怡霖,贾燕珺,等.内皮素1与冠状动脉钙化的相关性研究[J].中华老年心脑血管病杂志,2013.15(9):916-919.
6 Bedrov Ala,Maslevtsov DV,Tsvetkova EA,Moiseev AA.Ischemic heart disease and arterial hypertention as risk factors of surgical treatment of patients with infrarenal segment of aortic aneurysm[J].Vestn Khirlm I I Grek,2013,172(l):ll-15.
7靳钰,邱春光,侯允天,等.血管紧张素转换酶基因插入缺失多态性与原发性高血压患者合并心房颤动的相关性研究[J].中华老年心脑血管病杂志,2013,15(9):906-908.
8李雷,杨荣礼,李丽燕,等.厄贝沙坦氢氯噻嗪对血管内皮功能和高敏C反应蛋白的影响[J].中华老年心脑血管病杂志,2013,15(10):1033-1036.
9 Wani AH,Shah OJ,Zargar SA.Management of variceal hemorrhage in children with extrahepatic portal venous obstruction-shunt surgery versus endoscopic sclerotherapy[J].Indian J Surg,2011,73(6);409-413.
10严山,张学锋,田晓沂,等.瑞舒伐他汀联用贝那普利对老年单纯收缩期高血压患者脉压的影响[J].中华老年心脑血管病杂志,2013,15(9):931-933.
11 Tian Z,Liu YT,Fang Q,et al.Hemodynamic parameters obtained by transthoracic echocardiography and right heart catheterization;a comparative study in patients with pulmonary hypertension[J].Chin Med J(Engl),2011,124(12):1796-801.
12王颖.血清N末端B型钠尿肽前体在高血压左心室不同构型患者中的变化与检测意义[J].检验医学与临床,2013,10(16):2171-2172,2181.
13于建敏,陈晓星,何云.缬沙坦联合氨氯地平治疗糖尿病合并高血压病效果观察[J].临床误诊误治,2009,22(6):1-3.
14魏宇淼,程龙献.高血压的治疗进展:新药物、新技术与血压管理[J].临床心血管病杂志,2013,29(10):723-725.
15杨松,蒋颖,吴坚.缺血性脑卒中患者胱抑索c与颈动脉粥样硬化的关系[J].中华老年心脑血管病杂志,2013,15(10):1021-1023.
16杨静,李世平,李震中.尼莫地平注射液对脑出血急性期患者高血压调控的体会[J].脑与神经疾病杂志,2013.21(3):224-226.
17贾荣波,刘永选,王兆红.高血压患者强化管理与常规管理的比较研究[J].中国循环杂志,2013,28(5):360-363.
18刘华.厄贝沙坦联合硝苯地平对高血压患者心功能改善影响研究[J].北方药学,2013,10(10):36-37.