【摘要】 目的 :观察硝苯地平控释片对高血压病患者昼夜血压和脑血流变化的影响 ,并与苯那普利作对比。方法 :76例中度高血压病 (EH)患者随机分为两个治疗组 ,硝苯地平组口服硝苯地平控释片 30～ 6 0mg/d ,苯那普利组服苯那普利 10～ 2 0mg/d ,每日 1次 ,疗程 4周。治疗前后测定患者昼夜血压变化 ,监测动态血压同时 ,分别于 6Am和 4Pm 2次测量大脑中动脉 (MCA)的平均血流速度 (Vm)及血流脉动指数 (PI)。选 30例查体健康者作为对照组。结果 :治疗前 ,两组EH患者Vm明显低于对照组 ,PI明显高于对照组。经治疗 ,两组患者血压均明显下降 ,偶测血压 (CBP)临床疗效无显著差异 ,而硝苯地平控释片控制2 4h血压和改善Vm、PI明显优于苯那普利组。相关分析表明 ,治疗前后分别所测EH患者 4Pm和 6Am时Vm的变化程度(△Vm)分别与白昼平均血压 (dSBp、dDBp)和夜间平均血压 (nSBp、nDBp)的改善程度 (△dSBp、△dDBp和△nSBp、△nDBp)呈显著负相关 ,4Pm和 6Am时所测PI的变化程度 (△PI)分别与△dSBp、△dDBp和△nSBp、△nDBp呈显著正相关。结论 :高血压是影响脑血流变化的重要因素 ,硝苯地平控释片可更稳定地控制 2 4h动态血压变化 ,从而更好地改善脑血流变化更多还原

【Abstract】 Objective: To compare the effects of nifedipine GITS and benazepril on ambulatory blood pressure and cerebral hemodynamics in patients with essential hypertension. Methods: 76 patients with essential hypertension were randomly devided into two groups: nifedipine group and benazepril group. Nifedipine GITS tablet (30-60mg/d) and benazepril (10-20mg/d) were respectively given to the two groups. In all the patients, before and after treatment for 4 weeks, 24 hour ambulatory blood pressure?mean blood velocity (Vm) of middile cerebral artery (MCA) and blood pulse index(PI) of MCA were measured. Meanwhile, 30 healthy persons were chosen as control group. Results: Compared with those in the control group, the Vm of MCA was significantly declined and PI of MCA was significantly increased in patients with essential hypertension. After treatment for 4 weeks, clinical blood pressure (CBP) was significantly reduced by both drugs, while nifedipine GITS was better than benazepril in controlling 24 hour blood pressure and moreover, nifedipine GITS was more evident than benazepril in increasing Vm and in reducing PI. The analysis of linear correlation showed that, before and after treatment, the changes of Vm (△Vm) at 4Pm and at 6Am were inversely correlated with those of day mean SBP?DBP(△dSBP?△dDBP) and those of night mean SBP?DBP(△nSBP?△nDBP) respectively and that the changes of PI (△PI) at 4Pm and at 6Am were correlated with △dSBP?△dDBP and △nSBP?△nDBP respectively. Conclusion: Nifedipine GITS is more effective than benazepril on controlling ambulatory blood pressure, which is more beneficial for improving cerebral hemodynamics.更多还原