摘要
目的分析不同剂量培哚普利对高血压患者血压变异性及心脑血管事件发生率的影响。方法选取2019年2—11月扬州市中医院急诊科诊治的70例轻中度原发性高血压患者进行研究,采用随机数字表法将患者分为常规剂量组和大剂量组,每组各35例。其中,常规剂量组患者予以4 mg/d培哚普利,大剂量组予以8 mg/d培哚普利,治疗观察12周。比较两组治疗前后血压变异性、内皮素1(ET-1)、超敏C反应蛋白(hs-CRP)、纤维蛋白原(Fib)变化情况以及药物不良反应发生率、1年内心脑血管事件发生率。结果两组治疗前的24 h平均舒张压、24 h平均收缩压、24 h舒张压变异度、24 h收缩压变异度比较,差异无统计学意义(P>0.05)。治疗12周后,两组上述各项血压变异性指标均有改善,但大剂量组显著低于常规剂量组(P<0.05)。大剂量组患者治疗后的ET-1、hs-CRP、Fib检测值均显著低于常规剂量组(P<0.05)。大剂量组的药物不良反应总发生率为5.71%,与常规剂量组的2.86%相比,差异无统计学意义(P>0.05)。随访1年,大剂量组心脑血管事件总发生率为8.57%,明显低于常规剂量组的28.57%(P<0.05)。结论与常规剂量4 mg/d相比,应用大剂量8 mg/d培哚普利治疗原发性高血压效果更好,能够平稳降低血压,改善患者的血管内皮功能,进而有助于预防或减少心脑血管事件发生,且不会显著增加不良反应。
Objective To analyze the effects of different doses of perindopril on blood pressure variability(BPV)and incidence of cardio-cerebrovascular events in patients with essential hypertension.Methods Seventy patients with mild to moderate essential hypertension treated in the Emergency Department of Yangzhou Hospital of Traditional Chinese Medicine from February to November 2019 were randomly divided into the conventional dose group(n=35)and high dose group(n=35).Patients in the conventional dose group were treated with 4 mg/d perindopril and patients in the high dose group were treated with 8 mg/d perindopril.The patients were treated and observed for 12 weeks.The changes of BPV,endothelin-1(ET-1),hypersensitive C-reactive protein(hs-CRP),fibrinogen(Fib),the incidence of adverse drug reactions and cardio-cerebrovascular events within one year were compared between the two groups before and after treatment.Results There were no significant differences in 24-hour mean diastolic blood pressure,24-hour mean systolic blood pressure,24-hour diastolic blood pressure variability and 24-hour systolic blood pressure variability between the two groups before treatment(P>0.05).After 12 weeks of treatment,the above BPV indexes were improved in both groups,but the BPV in the high dose group was significantly lower than that in the conventional dose group(P<0.05).After treatment,the levels of ET-1,hs-CRP and Fib in the high dose group were significantly lower than those in the conventional dose group(P<0.05).The total incidence of adverse drug reactions in the high dose group was 5.71%,compared with 2.86%in the conventional dose group,with no statistically significant difference(P>0.05).During the 1-year follow-up,the total incidence of cardio-cerebrovascular events in the high-dose group was 8.57%,which was significantly lower than that in the conventional dose group(28.57%)(P<0.05).Conclusion Compared with conventional dose(4 mg/d),high-dose(8 mg/d)perindopril is more effective in the treatment of essential hypertension.High-dos
作者
张云娥
屈长宏
张荣生
ZHANG Yun'e;QU Changhong;ZHANG Rongsheng(Emergency Department,Yangzhou Hospital of Traditional Chinese Medicine,Jiangsu,Yangzhou 225000,China)
出处
《中国医药科学》
2021年第20期91-94,共4页
China Medicine And Pharmacy
关键词
原发性高血压
培哚普利
常规剂量
大剂量
Essential hypertension
Perindopril
Conventional dose
High d ose
