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非洛地平缓释片（Ⅱ）治疗老年原发性高血压的临床观察
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| 篇名： | 非洛地平缓释片（Ⅱ）治疗老年原发性高血压的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察非洛地平缓释片（Ⅱ）治疗老年原发性高血压的临床疗效，以及对动脉弹性、左心室重构和生活质量的改善作用。方法：将我院2014年8月－2015年12月收治的96例老年原发性高血压患者按随机数字表法分为观察组（50例）和对照组（46例）。观察组患者晨起空腹口服非洛地平缓释片（Ⅱ）5 mg，qd；对照组患者晨起空腹口服厄贝沙坦片150 mg，qd。两组患者均治疗12周。观察两组患者临床疗效及治疗前后24 h动态血压、动脉弹性指标[颈-桡动脉脉搏波传导速度（CR-PWV）、颈-股动脉脉搏波传导速度（CF-PWV）]、左心室重构指标[舒张期室间隔厚度（IVST）、舒张期左室后壁厚度（LPWT）、左室舒张末期内径（LVIDd）]。观察两组患者治疗前后健康调查简表（SF-36）生理功能（PF）、社会功能（SF）、生理职能（RP）、躯体疼痛（BP）、精神健康（MH）、情感职能（RE）、活力（VT）和总体健康（GH）评分，并比较不良反应发生情况。结果：两组患者临床总有效率比较，差异无统计学意义（P＞0.05）。治疗前，两组患者24 h动态血压、CR-PWV、CF-PWV、IVST、LPWT、LVIDd、SF-36各项评分比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者的24 h平均收缩压（24 hSBP）、24 h平均舒张压（24 hDBP）和24 h平均动脉压（24 hMAP）水平均显著降低， 且观察组24 hSBP和24 hMAP水平显著低于对照组，差异有统计学意义（P＜0.05），但24 hDBP水平比较，差异无统计学意义（P＞0.05）；观察组患者的CR-PWV、CF-PWV、IVST和LPWT水平均显著降低，对照组患者的CR-PWV和LPWT水平均显著降低，且观察组的CR-PWV、CF-PWV、IVST、LPWT、LVIDd水平显著低于对照组，差异均有统计学意义（P＜0.05）；两组患者SF-36各项评分显著升高，且观察组BP、VT、MH、GH评分显著高于对照组，差异均有统计学意义（P＜0.05），而PF、SF、RP、RE评分比较，差异均无统计学意义（P＞0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：非洛地平缓释片（Ⅱ）治疗老年原发性高血压降压疗效显著，血压波动性小，能够明显改善患者的生活质量，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy of Felodipine sustained-release tablets （Ⅱ） in the treatment of elderly essential hypertension and its improvement effect on arterial elasticity， left ventricular remodeling and the quality of life. METHODS： A total of 96 elderly patients with essential hypertension in our hospital during Aug. 2014-Dec. 2015 were divided into observation group （50 cases） and control group （46 cases） according to random number table. Observation group was given Felodipine sustained-release tablets （Ⅱ） 5 mg orally， qd， with empty stomach in the morning； control group was given Irbesartan tablets 150 mg， qd， with empty stomach in the morning. Both groups received treatment for 12 weeks. Clinical efficacies of 2 groups were observed as well as 24 h ambulatory blood pressure （ABP）， indexes of arlerial elasticity [carotid-radial pulse wave velocity （CR-PWV）， carotid-femoral pulse wave velocity （CF-PWV）]， indexes of left ventricular remodeling [diastolic interventricular septum thickness （IVST）， diastolic left ventricular posterior wall thickness （LPWT）， left ventricular end diastolic diameter （LVIDd）] before and after treatment. The physiological function （PF）， social function （SF）， role-physical （RP）， body pain （BP）， mental health （MH）， role-emotional （RE）， vitality （VT） and general health （GH） score of SF-36 were observed in 2 groups before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS： There was no statistical significance in total response rate between 2 groups （P＞0.05）. There was no statistical significance in 24 hABP， CR-PWV， CF-PWV， IVST， LPWT， LVIDd， SF-36 score between 2 groups before treatment （P＞0.05）. After treatment， the levels of 24 hSBP， 24 hDBP and 24 hMAP in 2 groups were decreased significantly， and 24 hSBP and 24 hMAP of observation groups were significantly lower than those of control group， with statistical significance （P＜0.05）. There was no statistical significance in 24 hDBP （P＞0.05）. The levels of CR-PWV， CF-PWV， IVST and LPWT in observation group were decreased significantly， and the levels of CR-PWV and LPWT in control group were also decreased significantly. The levels of CR-PWV， CF-PWV， IVST， LPWT and LVIDd in observation group were significantly lower than control group， with statistical significance （P＜0.05）. SF-36 scores of 2 groups were increased significantly， and the scores of BP， VT， MH and GH in observation group were significantly higher than control group， with statistical significance （P＜0.05）. There was no statistical significance in scores of PF， SF， RP and RE. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Felodipine sustained-release tablets （Ⅱ） exhibit significant effect and small blood pressure fluctuation in the treatment of elderly essential hypertension， and can improve the quality of life with good safety. |
| 期刊： | 2017年第28卷第14期 |
| 作者： | 周卓东，杨德志，韦颖 |
| AUTHORS： | ZHOU Zhuodong，YANG Dezhi，WEI Ying |
| 关键字： | 非洛地平；老年；原发性高血压；左心室重构；动脉弹性 |
| KEYWORDS： | Felodipine； Elderly； Essential hypertension； Left ventricular remodeling； Arterial elasticity |
| 阅读数： | 334 次 |
| 本月下载数： | 3 次 |
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