| 赵荫涛,杨莹莹,宋毅,等.比较国产马尼地平和氨氯地平对原发性高血压治疗效果的评价[J].安徽医药,2023,27(4):669-673. |
| 比较国产马尼地平和氨氯地平对原发性高血压治疗效果的评价 |
| Comparison of the effects of domestic manidipine and amlodipine in the treatment of essential hypertension |
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| DOI：10.3969/j.issn.1009-6469.2023.04.008 |
| 中文关键词: 高血压 马尼地平 动脉 弹性 尿蛋白 氨氯地平 |
| 英文关键词: Hypertension Manidipine Arteries Elasticity Proteinuria Amlodipine |
| 基金项目:河南省科技攻关基金资助项目( 182102310099) |
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| 中文摘要: |
| 目的比较国产马尼地平与氨氯地平对原发性轻中度高血压病人降压效果、动脉弹性和尿微量白蛋白( MAU)的影响。方法选取郑州大学第一附属医院 2020年 5月至 2021年 6月门诊和住院就诊的 260例新发轻中度高血压病人纳入本研究，随机数字表法分为马尼地平组和氨氯地平组，马尼地平组口服国产马尼地平 10 mg/d和氨氯地平模拟剂，氨氯地平组口服氨氯地平 5 mg/d和马尼地平模拟剂， 1个月后血压高于 140/90 mmHg病人，服用药物剂量加倍。服药前和服药 2、6个月后分别检测动脉弹性指标:肱踝动脉传导速度( baPWV)、大动脉弹性指数 C1和小动脉弹性指数 C2，以及 MAU。结果降压治疗 2个月后马尼地平组和氨氯地平组收缩压( SBP)［(134.16±13.25)mmHg比( 156.32±15.36)mmHg，(132.96±14.80)mmHg比( 155.49± 17.67)mmHg］较治疗前明显降低( P<0.05)，舒张压( DBP)［( 84.43±7.63)mmHg比( 103.08±10.17)mmHg，(83.86±7.82)mmHg比(100.41±10.40)mmHg］较治疗前也明显降低( P<0.05)。马尼地平组血压达标率 83.84%，氨氯地平组血压达标率 90.00%，两组间差异无统计学意义。 baPWV在治疗 2个月后马尼地平组(1 790.18±399.34)cm/s和氨氯地平组( 1 746.85±374.46)cm/s较治疗前( 1 958.99±514.85)cm/s、(2 071.50±552.95)cm/s明显降低( P<0.05)，治疗 6个月后较治疗 2个月后两组 baPWV进一步降低［( 1 557.27±359.06)cm/s比( 1 790.18±399.34)cm/s，(1 599.46±346.61)cm/s比( 1 746.85±374.46)cm/s，P<0.05］。大动脉弹性指数 C1在治疗 6个月后与治疗前比较，马尼地平组和氨氯地平组均明显升高( P<0.05)。小动脉弹性指数 C2在治疗 2个月后，马尼地平组较治疗前明显升高( P<0.05)对比治疗前，治疗 6个月后马尼地平组和氨氯地平组均明显升高( P<0.05)两组小动脉 |
| 英文摘要: |
| Objective To compare the effects of domestic manidpine and amlodipine on antihypertensive effects, arterial elasticityand urinary microalbumin (MAU) in patients with primary mild to moderate hypertension.Methods A total of 260 patients with new-onset mild to moderate hypertension admitted to The First Affiliated Hospital of Zhengzhou University from May 2020 to June 2021 inboth outpatient and inpatient settings were selected for inclusion in this study and were divided into the manidipine and amlodipinegroups by the random number table method. The manidipine group received oral domestic manidipine 10 mg/d and amlodipine mimetic, and the amlodipine group received oral amlodipine 5 mg/d and manidipine mimetic. Patients with blood pressure above 140/90mmHg after 1 month were given double the dose of the drug. Arterial elasticity indices were measured before and after 2 and 6 monthsof drug administration: brachial-ankle pulse wave velocity (baPWV), large artery elasticity index C1 and small artery elasticity indexC2, and microalbuminuria (MAU). Results After 2 months of antihypertensive treatment, systolic blood pressure (SBP) [(134.16± 13.25) mmHg vs. (156.32±15.36) mmHg, (132.96±14.80) mmHg vs. (155.49±17.67) mmHg] was significantly lower in the manidipine and amlodipine groups compared to pretreatment (P<0.05), and diastolic blood pressure (DBP) [(84.43±7.63) mmHg vs. (103.08±10.17) mmHg,(83.86±7.82) mmHg vs. (100.41±10.40) mmHg] was also significantly lower than before treatment (P<0.05). The blood pressure compliance rate was 83.84% in the manidipine group and 90.00% in the amlodipine group, with no statistically significant differencebetween the two groups. BaPWV was significantly decreased in the two groups [(1 790.18±399.34) cm/s vs. (1 958.99±514.85) cm/s, (1 746.85±374.46) cm/s vs. (2 071.50±552.95) cm/s] after 2 months of treatment (P < 0.05). BaPWV was further reduced in both groups after 6 months of treatment compared to after 2 months of treatment [(1 557.27±359.06) cm/s compared to (1 790.18±399.34) cm/s and (1599.46±346.61) cm/s compared to (1 746.85±374.46) cm/s] (P < 0.05). The large artery elasticity index C1 was significantly higher inboth the manidipine and amlodipine groups after 6 months of treatment than before the treatment (P < 0.05). The small artery elasticityindex C2 was significantly higher in the manidipine group after 2 months of treatment than before treatment (P < 0.05), and comparedwith before treatment, it was significantly higher in both the manidipine and amlodipine groups after 6 months of treatment (P < 0.05).The small artery elasticity index C2 was further reduced in both groups after 6 months of treatment compared with 2 months of treatment. MAU decreased significantly in the manidipine group after 2 and 6 months of treatment compared with before treatment (P < 0.05) and decreased further after 6 months of treatment compared with after 2 months of treatment (P < 0.05). There was no significant change in MAU before and after treatment in the amlodipine group.Conclusion Domestic manidipine was as effective as amlodipinein controlling blood pressure and ameliorating arterial compliance in patients with primary mild to moderate hypertension and was superior to amlodipine in reducing MAU. |
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