氨氯地平与左旋氨氯地平降压作用及对高血压患者血管内皮功能影响的对比研究

摘要

目的：比较氨氯地平与左旋氨氯地平的降压作用及对高血压患者血管内皮功能的影响。方法选取2014年1月—2016年1月华中科技大学同济医学院附属荆州医院收治的高血压患者200例，随机分为 A 组和 B 组，每组100例。A 组患者予以氨氯地平治疗，B 组患者予以左旋氨氯地平治疗；两组患者均连续治疗6周。比较两组患者治疗前后血压〔收缩压（SBP）、舒张压（DBP）〕、心率（HR）、指尖脉搏容积（PAV）、肱动脉血流介导性血管扩张（FMD）、血浆一氧化氮（NO）及内皮素1（ET-1）水平。结果治疗前后两组患者 SBP、DBP、HR 比较，差异无统计学意义（P >0.05）。治疗前两组患者 PAV、FMD 比较，差异无统计学意义（ P >0.05）；治疗后 A 组患者 PAV、FMD 高于 B 组（ P <0.05）。Pearson 相关性分析结果显示，A、B 组患者 PAV 分别与 FMD 呈正相关（ r 值分别为0.781、0.862，P <0.05）。治疗前两组患者血浆 NO、ET-1水平比较，差异无统计学意义（P >0.05）；治疗后 A 组患者血浆 NO 水平高于 B 组，血浆 ET-1水平低于 B 组（P <0.05）。结论氨氯地平与左旋氨氯地平降压作用相当，而氨氯地平对患者血管内皮功能的保护作用较好。%Objective To compare the antihypertensive effect and impact on vascular endothelial function in hypertension patients between amlodipine and levamlodipine. Methods From January 2014 to January 2016,a total of 200 hypertension patients were selected in the Jingzhou Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,and they were randomly divided into A group and B group,each of 100 cases. Patients of A group were given amlodipine,while patients of B group were given levamlodipine;both groups continuously treated for 6 weeks. Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),pulse amplitude volume(PAV),brachial artery flow -mediated vasodilation(FMD),plasma level of NO and ET-1 before and after treatment were compared between the two groups. Results No statistically significant differences of SBP,DBP or HR was found between the two groups before treatment or after treatment(P > 0. 05). No statistically significant differences of PAV or FMD was found between the two groups before treatment (P > 0. 05),while PAV and FMD of A group were statistically significantly higher than those of B group after treatment(P <0. 05). Pearson correlation analysis showed that,PAV of A group and B group was positively correlated with FMD,respectively (r = 0. 781,0. 862,P < 0. 05). No statistically significant differences of plasma level of NO or ET-1 was found between the two groups before treatment(P > 0. 05);after treatmen,plasma NO level of A group was statistically significantly higher than that of B group,while plasma ET-1 level of A group was statistically significantly lower than that of B group(P < 0. 05). Conclusion Amlodipine has similar antihypertensive effect with levamlodipine in hypertension patients,while amlodipine has better protective effect on vascular endothelial function.