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西拉普利与氨氯地平对老年原发性高血压患者QT离散度与心率变异性的影响(1)
http://www.100md.com 2015年7月5日 中国医药导报2015年第19期
     [摘要] 目的 探讨西拉普利与氨氯地平对老年原发性高血压患者QT离散度与心率变异性的影响。 方法 选择2012年9月~2014年8月广东省深圳市宝安区石岩人民医院收治的84例老年原发性高血压患者为研究对象,采用随机数字表法将其分为观察组与对照组,各42例,在常规对症治疗的基础上,观察组给予西拉普利片口服治疗,对照组给予苯磺酸氨氯地平口服治疗,两组疗程均为12周。比较两组患者治疗前后血压、QT离散度、心率变异性及药物不良反应发生率。 结果 治疗后,观察组和对照组收缩压、舒张压比较差异无统计学意义[(140.8±14.8)比(141.9±15.5)mm Hg,(86.9±7.6)比(87.7±7.6)mm Hg](t = 0.332、0.482,均P > 0.05);观察组QT离散度明显低于对照组[(51.4±18.3)比(59.5±17.6)],差异有统计学意义(t = 2.067,P < 0.05);观察组24 h全程正常R-R间期总体标准差(SDNN)、24 h内每连续5 min时段正常R-R间期标准差的平均值(SDANN)、全部正常连续R-R间期差值的平方根(RMSSD)、相邻正常R-R间期差值>50 ms的窦性心律占心搏总数的百分比(PNN50)明显高于对照组[(121.8±13.1)比(108.3±12.6)ms,(104.5±12.0)比(92.7±9.3)ms,(34.1±6.2)比(30.2±4.7)ms,(7.9±2.0)%比7.0±1.8)%],差异有统计学意义(t = 4.813、5.037、3.248、2.167,均P < 0.05);观察组和对照组不良反应发生率比较差异无统计学意义(21.4%比23.8%)(χ2=0.068,P > 0.05)。 结论 西拉普利与氨氯地平治疗老年原发性高血压患者,能够有效控制血压,改善心率变异性,降低药物不良反应;西拉普利有助于降低QT离散度,综合优势优于氨氯地平。

    [关键词] 西拉普利;氨氯地平;老年原发性高血压;QT离散度;心律变异性

    [中图分类号] R544.1 [文献标识码] A [文章编号] 1673-7210(2015)07(a)-0132-04

    [Abstract] Objective To study effect of Cilazapril and Amlodipine on QT dispersion and heart rate variability of senile essential hypertension. Methods 84 cases of patients with senile essential hypertension from September 2012 to August 2014 in Shiyan People's Hospital of Bao'an District in Shenzhen City were selected as research objects, and they were divided into observation group and control group according to the random number table, with 42 cases in each group. On basis of conventional symptomatic treatment, the observation group was given Cilazapril orally, control group was added with Amlodipine. Blood pressure, QT discrete degree, heart rate variability and adverse reactions were compared between two groups. Results After treatment, there were no statistically significant differences of systolic pressure, diastolic pressure between obser vation group and control group [(140.8±14.8) vs (141.9±15.5) mm Hg, (86.9±7.6) vs (87.7±7.6) mm Hg] (t = 0.332, 0.482, all P > 0.05); QT the dispersion degree of observation group was significantly lower than that of control group [(51.4±18.3) vs (59.5±17.6)], the difference was statistically significant (t = 2.067, P < 0.05). SDNN, SDANN, RMSSD, PNN50 were significantly higher than those of control group [(121.8±13.1) vs (108.3±12.6) ms, (104.5±12.0) vs (92.7±9.3) ms, (34.1±6.2) vs (30.2±4.7) ms, (7.9±2.0)% vs (7.0±1.8)%], the differences were statistically significant (t = 4.813, 5.037, 3.248, 2.167, all P < 0.05). There was no statistically significant difference of adverse reactions between observation group and control group (21.4% vs 23.8%) (χ2=0.068, P > 0.05). Conclusion Cilazapril and Amlodipine therapy in senile essential hypertension can effectively control blood pressure, improve heart rate variability, reduce adverse drug reactions; Cilazapril helps to reduce QT dispersion degree, comprehensive advantage is better than Amlodipine. (卢永鑫 林丽如)
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