中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2010年
8期
728-733
,共6页
徐电%余静%刘培君%郭雪娅%胡浩%常鹏%赵锋%李秀丽%陈雪红%申希平%张怡%白锋
徐電%餘靜%劉培君%郭雪婭%鬍浩%常鵬%趙鋒%李秀麗%陳雪紅%申希平%張怡%白鋒
서전%여정%류배군%곽설아%호호%상붕%조봉%리수려%진설홍%신희평%장이%백봉
高血压%性功能%药物治疗%女性
高血壓%性功能%藥物治療%女性
고혈압%성공능%약물치료%녀성
Hypertension%Sexual function%Drug therapy%Female
目的 探讨以非洛地平为基础的联合降压方案在降压达标的基础上对中青年女性高血压病患者性功能的影响.方法 研究采用前瞻性、随机、平行、对照、开放、固定治疗的设计方案.选择2008-2009年在兰州大学第二医院就诊的中青年(年龄18～60岁)女性1～2级高血压病患者99例,随机分2组:非洛地平缓释片5 mg/d+厄贝沙坦片150 mg/d(F+I组,n=49),非洛地平缓释片5 mg/d+琥珀酸美托洛尔片47.5 mg/d(F+M组,n=50).以美国女性性功能指数量表(FSFI)进行问卷调查并检测血清雌二醇和总睾酮的含量,随访24周.FSFI总分以小于25.5定义为性功能障碍,以血压＜140/90 mm Hg(1 mm Hg=0.133 kPa)为达标.结果 F+I组与F+M组治疗第4、8、12周和第24周血压达标率分别为42.9%比62.0%、89.8%比90.0%、93.9%比94.0%和98.0%比96.0%,两组之间比较差异均无统计学意义(均P＞0.05).绝经前与绝经后患者在F+I组治疗后性欲指数和性唤起功能指数均升高(P分别＜0.05或＜0.01),雌二醇水平升高[绝经前:(50.3±37.4)pg/L比(54.4±10.8)pg/L,绝经后:(18.4±2.9)pg/L比(20.2±3.1)pg/L,P分别＜0.05或＜0.01],睾酮水平下降[绝经前:(722.8±277.1)ng/L比(650.0±156.0)ng/L,绝经后:(841.2±279.3)ng/L比(761.9±197.8)ng/L,P分别＜0.05或＜0.01];在F+M组治疗后性欲指数和阴道湿润度指数均降低(均P＜0.01),雌二醇水平降低[绝经前:(57.4±9.7)pg/L比(51.1±12.1)pg/L,绝经后:(19.8±2.3)pg/L比(17.8±3.3)pg/L,均P＜0.01],睾酮水平升高[绝经前:(775.6±217.8)ng/L比(886.0±186.4)ng/L,绝经后:(812.5±311.3)ng/L比(914.4±300.2)ng/L,均P＜0.01].高血压组FSFI总分与年龄和收缩压水平均呈负相关(均P＜0.01).结论 非洛地平缓释片与厄贝沙坦片或琥珀酸美托洛尔片联合降压达标率相同.前者可以在一定程度改善女性高血压病患者性功能.
目的 探討以非洛地平為基礎的聯閤降壓方案在降壓達標的基礎上對中青年女性高血壓病患者性功能的影響.方法 研究採用前瞻性、隨機、平行、對照、開放、固定治療的設計方案.選擇2008-2009年在蘭州大學第二醫院就診的中青年(年齡18～60歲)女性1～2級高血壓病患者99例,隨機分2組:非洛地平緩釋片5 mg/d+阨貝沙坦片150 mg/d(F+I組,n=49),非洛地平緩釋片5 mg/d+琥珀痠美託洛爾片47.5 mg/d(F+M組,n=50).以美國女性性功能指數量錶(FSFI)進行問捲調查併檢測血清雌二醇和總睪酮的含量,隨訪24週.FSFI總分以小于25.5定義為性功能障礙,以血壓＜140/90 mm Hg(1 mm Hg=0.133 kPa)為達標.結果 F+I組與F+M組治療第4、8、12週和第24週血壓達標率分彆為42.9%比62.0%、89.8%比90.0%、93.9%比94.0%和98.0%比96.0%,兩組之間比較差異均無統計學意義(均P＞0.05).絕經前與絕經後患者在F+I組治療後性欲指數和性喚起功能指數均升高(P分彆＜0.05或＜0.01),雌二醇水平升高[絕經前:(50.3±37.4)pg/L比(54.4±10.8)pg/L,絕經後:(18.4±2.9)pg/L比(20.2±3.1)pg/L,P分彆＜0.05或＜0.01],睪酮水平下降[絕經前:(722.8±277.1)ng/L比(650.0±156.0)ng/L,絕經後:(841.2±279.3)ng/L比(761.9±197.8)ng/L,P分彆＜0.05或＜0.01];在F+M組治療後性欲指數和陰道濕潤度指數均降低(均P＜0.01),雌二醇水平降低[絕經前:(57.4±9.7)pg/L比(51.1±12.1)pg/L,絕經後:(19.8±2.3)pg/L比(17.8±3.3)pg/L,均P＜0.01],睪酮水平升高[絕經前:(775.6±217.8)ng/L比(886.0±186.4)ng/L,絕經後:(812.5±311.3)ng/L比(914.4±300.2)ng/L,均P＜0.01].高血壓組FSFI總分與年齡和收縮壓水平均呈負相關(均P＜0.01).結論 非洛地平緩釋片與阨貝沙坦片或琥珀痠美託洛爾片聯閤降壓達標率相同.前者可以在一定程度改善女性高血壓病患者性功能.
목적 탐토이비락지평위기출적연합강압방안재강압체표적기출상대중청년녀성고혈압병환자성공능적영향.방법 연구채용전첨성、수궤、평행、대조、개방、고정치료적설계방안.선택2008-2009년재란주대학제이의원취진적중청년(년령18～60세)녀성1～2급고혈압병환자99례,수궤분2조:비락지평완석편5 mg/d+액패사탄편150 mg/d(F+I조,n=49),비락지평완석편5 mg/d+호박산미탁락이편47.5 mg/d(F+M조,n=50).이미국녀성성공능지수량표(FSFI)진행문권조사병검측혈청자이순화총고동적함량,수방24주.FSFI총분이소우25.5정의위성공능장애,이혈압＜140/90 mm Hg(1 mm Hg=0.133 kPa)위체표.결과 F+I조여F+M조치료제4、8、12주화제24주혈압체표솔분별위42.9%비62.0%、89.8%비90.0%、93.9%비94.0%화98.0%비96.0%,량조지간비교차이균무통계학의의(균P＞0.05).절경전여절경후환자재F+I조치료후성욕지수화성환기공능지수균승고(P분별＜0.05혹＜0.01),자이순수평승고[절경전:(50.3±37.4)pg/L비(54.4±10.8)pg/L,절경후:(18.4±2.9)pg/L비(20.2±3.1)pg/L,P분별＜0.05혹＜0.01],고동수평하강[절경전:(722.8±277.1)ng/L비(650.0±156.0)ng/L,절경후:(841.2±279.3)ng/L비(761.9±197.8)ng/L,P분별＜0.05혹＜0.01];재F+M조치료후성욕지수화음도습윤도지수균강저(균P＜0.01),자이순수평강저[절경전:(57.4±9.7)pg/L비(51.1±12.1)pg/L,절경후:(19.8±2.3)pg/L비(17.8±3.3)pg/L,균P＜0.01],고동수평승고[절경전:(775.6±217.8)ng/L비(886.0±186.4)ng/L,절경후:(812.5±311.3)ng/L비(914.4±300.2)ng/L,균P＜0.01].고혈압조FSFI총분여년령화수축압수평균정부상관(균P＜0.01).결론 비락지평완석편여액패사탄편혹호박산미탁락이편연합강압체표솔상동.전자가이재일정정도개선녀성고혈압병환자성공능.
Objective To compare the effects between felodipine plus irbesartan and felodipine plus metoprolol regimen on blood pressure and the sexual function in young and middle-aged hypertensive women. Methods In this prospective, randomized, parallelized, controlled and fixed combined therapy trial, 99 female patients(aged 18 to 60)with grade 1 and grade 2 hypertension(BP ≥ 140/90 mm Hg and ＜ 179/109 mm Hg, 1 mm Hg =0.133 kPa)were assigned to felodipine 5 mg q.d + irbesartan 150 mg q.d(F + I group, n = 49)and felodipine 5 mg q. d + metoprolol 47.5 mg q. d(F + M group, n = 50)group. Target blood pressure was ＜ 140/90 mm Hg. The female sexual function index(FSFI)questionnaire, levels of serum estradiol and testosterone were assessed. Female sexual dysfunction was defined as a FSFI score of less than 25.5. Patients were followed up for 24 weeks. Results The rate of achieving blood pressure goal between 2 groups was similar at the 4th, 8th, 12th and 24th weeks respectively (42.9% vs. 62.0% at 4th week, 89.8% vs. 90.0% at 8th week, 93.9% vs. 94.0% at 12th week,98.0% vs. 96.0% at 24th week, P ＞ 0.05). Compared to baseline, scores for the items related to"desire" and "arousal" were significantly improved(P ＜ 0.05), the level of the serum estradiol was significantly elevated[(50.3 ± 37.4)pg/L vs.(54.4 ± 10.8)pg/L before menopause,(18.4 ± 2.9)pg/L vs.(20.2 ±3.1)pg/L after menopause, P ＜0.05]and the level of the serum testosterone was significantly decreased[(722.8 ± 277.1)ng/L vs.(650.0 ± 156.0)ng/L before menopause,(841.2 ± 279.3)ng/L vs.(761.9 ± 197.8)ng/L after menopause, P ＜ 0.05]in the F + I group, while scores for the items related to" sexual desire" and "lubrication" were statistically reduced(P ＜ 0.01), the concentration of the serum estradiol was significantly reduced[(57.4 ± 9.7)pg/L vs.(51.1 ± 12.1)pg/L before menopause,(19.8±2.3)pg/L vs.(17.8 ± 3.3)pg/L after menopause, P ＜0.01]and the level of the serum testosterone was significantly increased[(775.6 ± 217.8)ng/L vs.(886.0 ± 186.4)ng/L before menopause,(812.5 ± 311.3)ng/L vs.(914.4 ± 300.2)ng/L after menopause, P＜0.01]in the F+M group. FSFI score was negatively correlated with age and systolic blood pressure levels. Conclusion felodipine plus irbesartan or metoprolol for 24 weeks equally reduced blood pressure and the former regimen is superior to the latter on sexual function improvement in this patient cohort.
