摘要
应用诊室血压（ＣＢＰ）和动态血压监测（ＡＢＰＭ）方法比较硝苯地平控释片（ＮＩ）与氨氯地平（ＡＭ）的疗效、最大效应时间、降压效应谷／峰比率（降压Ｔ／Ｐ）及不良反应。采用随机、单盲、平行对照法。研究对象均先服安慰剂每日１片，共２周。ＮＩ组１５例，初始剂量为３０ｍｇ／ｄ、晨８时服，１周末有６例因未达显效而增量为６０ｍｇ／ｄ，全程共４周。ＡＭ组１５例，均为５ｍｇ／ｄ，共４周。在服安慰剂期末及治疗１、２、４周末测ＣＢＰ、心率并记录症状、体征；于服安慰剂期末及治疗２、４周末各行２４小时ＡＢＰＭ１次。ＣＢＰ结果显示４周末总有效率ＮＩ组１００％，ＡＭ组８０％，组间比较差异无显著性；ＡＭ组治疗２、４周末ＤＢＰ分别下降１．５±０．７ｋＰａ（１１．３±５．４ｍｍＨｇ）、１．９±０．７ｋＰａ（１４．１±５．４ｍｍＨｇ），Ｐ＜０．０５，而ＮＩ组治疗２、４周血压下降值间差异无显著性。ＡＢＰＭ结果显示两组药后血压负荷均降低，各时点血压均较治疗前下降，且均可保持血压的昼夜时辰节律，但ＮＩ组疗效略优于ＡＭ组；两组降压Ｔ／Ｐ均大于５０％，而ＮＩ组略高于ＡＭ组。两组不良反应均较轻，ＮＩ组不良反应略多于ＡＭ组。本研究结果表明，ＮＩ３０～６０ｍｇ／?
Inordertocomparetheeficacy,thetimeofthemaximumefect,troughtopeakra-tios(T/P)oftheantihypertensiveeffectandside-efectsofnifedipineGITS(NI,i.e.adalatGITS)andamlodipine(AM),thirtypatientswithmildtomoderateessentialhypertension(sitingdiastolicbloodpressure,DBP,95 114mmHg)wereinvestigatedbyrandomizedsingle-blindmethodwithei-therNI(30-60mgonce-daily,n=15)orAM(5mgonce-daily,n=15)treatmentfor4weeks.Clini-calbloodpressure(CBP),heartrate(HR)andside-efectswereassessedduringthetwoweekswash-outperiodonplacebo,andafter1-,2-and4-weektreatment.CBPandHRweremeasuredatthesametimeateachvisitbetween8:00to9:00o′clock.Ambulatorybloodpressuremonitoring(ABPM)wasperformedovera24-hourperiodatbaselineandattheendofboth2-and4-weekstreatment.BPandHRwereregisteredautomaticalyat20-minintervalduringday(from06:00to22:00)andat30-minintervalduringnight(from22:00to06:00)usingSpace-labs90207.Nosigni-ficantdifferencewasfoundintheefectiveratebetweenNIandAMgroup(100%vs80%).CBPwassignificantlyreducedbybothtreatmentregimens.TherewassignificantdifferencebetweentheDBPdecreaseattheendof2-and4-weekstreatmentwithAM(-11.3mmHgand-14.1mmHg,P<0.05),whiletherewasnosignificantdifferenceinNIgroup.BothdrugshadnoefectonthecircadianrhythmofBP.ThetroughtopeakratiosforSBPandDBPweremorethan50%andgreaterinNIgroupthanthatinAMgroup.NIcausedmoreside-effectsthanAM,suchasedemaandheadache.Nopatientwasofwithdrawalduetoside-efects.Thisstudydemonstratedthattheeffica-cyofNI30 60mgonce-dailywassimilartothatofAM5mgonce-dailyafter4weektreatment.ThetimeofthemaximumantihypertensiveefectofAM(3 4weeks)wasmuchlaterthanthatofNI(1week).BothNIandAM,whichhadsustainedantihypertensiveefectovera24-hourperiodwithanacceptableT/PratioandnoinfluenceoncircadianrhythmofBP,mightbeprospectiveantihyperten-sivedrugs.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
1996年第2期92-96,共5页
Chinese Journal of Cardiology
关键词
高血压
硝苯地平
控释片
氨氯地平
hypertensionnifedipineGITSamlodipinebloodpressuredetermination
