中国临床新医学
中國臨床新醫學
중국림상신의학
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
2015年
6期
491-495
,共5页
吴隐雄%王小燕%张琴%赵毅兰%邓金龙%吴东峰%刘杰%廖钦晨%王舟%卢锋
吳隱雄%王小燕%張琴%趙毅蘭%鄧金龍%吳東峰%劉傑%廖欽晨%王舟%盧鋒
오은웅%왕소연%장금%조의란%산금룡%오동봉%류걸%료흠신%왕주%로봉
氨氯地平%高血压%靶器官
氨氯地平%高血壓%靶器官
안록지평%고혈압%파기관
Amlodipine%Hypertension%Target organ
目的:探讨氨氯地平降压治疗对老年轻中度高血压患者颈动脉内-中膜厚度( IMT)、肾功能及心脏结构与功能的影响。方法选取40例轻中度老年原发性高血压患者,经氨氯地平(5~10 mg/d)治疗血压达标后,维持治疗。随访半年至一年,观察IMT、肾功能以及心脏结构与功能的变化。结果高血压患者服用氨氯地平半年后,收缩压较服药前无明显下降(P>0.05),仅舒张压较治疗前显著下降(P<0.05);治疗一年后,收缩压和舒张压较治疗前下降( P均<0.05)。24 h动态血压在服药半年及一年后均较治疗前有显著下降(P均<0.01)。与服药前相比较,治疗半年及一年后的IMT明显降低(P均<0.01);尿β2-微球蛋白(β2M)、微量白蛋白(ALB)及血肌酐明显低于治疗前(P均<0.01);左室舒张末内径(LVEDd)较治疗前有所增加,二尖瓣舒张期血流A峰速度( PAV)较治疗前有明显下降,E/A比值较治疗前有显著升高( P均<0.01);左心室重量指数(LVMI)、室间隔厚度(IVST)、左室后壁厚度(PWT)、二尖瓣舒张期血流E峰速度(PEA)和左室射血分数( EF)的均值较治疗前均无明显差异。结论服用氨氯地平降压治疗后,对颈动脉IMT、肾功能有明显改善作用,并且能改善心脏舒张功能,但对收缩功能无明显改善。
目的:探討氨氯地平降壓治療對老年輕中度高血壓患者頸動脈內-中膜厚度( IMT)、腎功能及心髒結構與功能的影響。方法選取40例輕中度老年原髮性高血壓患者,經氨氯地平(5~10 mg/d)治療血壓達標後,維持治療。隨訪半年至一年,觀察IMT、腎功能以及心髒結構與功能的變化。結果高血壓患者服用氨氯地平半年後,收縮壓較服藥前無明顯下降(P>0.05),僅舒張壓較治療前顯著下降(P<0.05);治療一年後,收縮壓和舒張壓較治療前下降( P均<0.05)。24 h動態血壓在服藥半年及一年後均較治療前有顯著下降(P均<0.01)。與服藥前相比較,治療半年及一年後的IMT明顯降低(P均<0.01);尿β2-微毬蛋白(β2M)、微量白蛋白(ALB)及血肌酐明顯低于治療前(P均<0.01);左室舒張末內徑(LVEDd)較治療前有所增加,二尖瓣舒張期血流A峰速度( PAV)較治療前有明顯下降,E/A比值較治療前有顯著升高( P均<0.01);左心室重量指數(LVMI)、室間隔厚度(IVST)、左室後壁厚度(PWT)、二尖瓣舒張期血流E峰速度(PEA)和左室射血分數( EF)的均值較治療前均無明顯差異。結論服用氨氯地平降壓治療後,對頸動脈IMT、腎功能有明顯改善作用,併且能改善心髒舒張功能,但對收縮功能無明顯改善。
목적:탐토안록지평강압치료대노년경중도고혈압환자경동맥내-중막후도( IMT)、신공능급심장결구여공능적영향。방법선취40례경중도노년원발성고혈압환자,경안록지평(5~10 mg/d)치료혈압체표후,유지치료。수방반년지일년,관찰IMT、신공능이급심장결구여공능적변화。결과고혈압환자복용안록지평반년후,수축압교복약전무명현하강(P>0.05),부서장압교치료전현저하강(P<0.05);치료일년후,수축압화서장압교치료전하강( P균<0.05)。24 h동태혈압재복약반년급일년후균교치료전유현저하강(P균<0.01)。여복약전상비교,치료반년급일년후적IMT명현강저(P균<0.01);뇨β2-미구단백(β2M)、미량백단백(ALB)급혈기항명현저우치료전(P균<0.01);좌실서장말내경(LVEDd)교치료전유소증가,이첨판서장기혈류A봉속도( PAV)교치료전유명현하강,E/A비치교치료전유현저승고( P균<0.01);좌심실중량지수(LVMI)、실간격후도(IVST)、좌실후벽후도(PWT)、이첨판서장기혈류E봉속도(PEA)화좌실사혈분수( EF)적균치교치료전균무명현차이。결론복용안록지평강압치료후,대경동맥IMT、신공능유명현개선작용,병차능개선심장서장공능,단대수축공능무명현개선。
Objective To detect the changes of the carotid artery intima media thickness( IMT) , renal func-tion, cardiac structure and function in elderly patients with mild-to-moderate hypertension after antihypertensive treat-ment of amlodipine.Methods Forty elderly patients with mild to moderate primary hypertension were selected, and their parameters of IMT, renal function, cardiac structure and function were recorded with the follow-up of six to twelve months after the treatment of amlodipine.Results After treating with amlodipine for six months, the systolic blood pressure was not significantly decreased ( P>0.05 ) , while the diastolic blood pressure was significantly de-creased(P<0.01); After one year′s treatment, the systolic blood pressure and diastolic blood pressure were both significanthy decreased( P<0.01) .The 24 h ambulatory blood pressure significantly decreased after six months and one year′s treatment (P<0.01).After six months to one year′s treatment, IMT was significantly decreased(P<0.05);Urinary β2 microglobulin(β2M), albumin(ALB) and plasma creatinine were significantly decreased(P<0.01);The left ventricular end-diastolic dimension(LVEDd) and the E/A ratio were significantly increased, while the maximum diastolic mitral A-wave velocity measurement(PAV) was significantly decreased(P<0.01); The left ventricular mass index(LVMI), interventricular septum thickness(IVST), left ventricular posterior wall thickness ( PWT) , maximum diastolic mitral E-wave velocity measurement ( PEV ) , and left ventricular ejection fraction ( LVEF) were not significantly changed.Conclusion Antihypertensive therapy of amlodipine improves carotid IMT, renal function and heart diastolic function.