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目的:用动态血压监测(ABPM)的方法比较两种钙拮抗剂(贝尼地平与氨氯地平)治疗原发性高血压的疗效。方法:选择原发性高血压患者44例,随机分为贝尼地平组20例,氨氯地平组24例。分别观察服药前和服药后(8周末)的24 h、白昼、夜间及各时点的动态血压变化。结果:(1)贝尼地平组和氨氯地平组服药前后(8周末)的24h、白昼和夜间的平均收缩压/舒张压均明显下降(P均<0.05)。贝尼地平组和氨氯地平组服药后(8周末)绝大部分时点收缩压和舒张压均较服药前下降(P<0.05)。24h、白昼和夜间的平均收缩压/舒张压下降值在贝尼地平组分别为(9.52±4.21)/(6.34±3.08),(11.63±3.32)/(7.46±2.80),(5.30±2.04)/(4.11±2.40)mmHg(p<0.05);在氨氯地平组则分别为(12.36±1.99)/(7.95±1.84),(11.97±1.84)/(8.24±1.66),(12.69±2.08)/(6.90±1.34)mmHg(P<0.05)。但两组间上述指标比较无显著性差异(P>0.05)。(2)谷峰比:贝尼地平组和氨氯地平组SBP分别为:65％、95％;DBP分别为62％,69％。(3)不良反应发生率:贝尼地平组低于氨氯地平组,但两组间差异无统计学意义。结论:贝尼地平(4—8mg/d)或氨氯地平(5～10mg/d),对每日1次口服治疗原发性高血压患者均可以维持24小时平稳降压。
AIM: To compare the efficacy of two calcium antagonists (benidipine and amlodipine) in the treatment of essential hypertension with ambulatory blood pressure monitoring (ABPM). Methods: Forty-four patients with essential hypertension were randomly divided into benidipine group (n = 20) and amlodipine group (n = 24). The changes of ambulatory blood pressure during daytime, nighttime and at different time points were observed before medication and after medication (8weeks) respectively. Results: (1) The mean systolic / diastolic blood pressure in both benidipine and amlodipine groups decreased significantly (all P <0.05) 24h before and after taking the drug (8weeks). Benidipine group and amlodipine group after taking medicine (8 weekend) most of the time systolic and diastolic blood pressure were lower than before medication (P <0.05). (9.52 ± 4.21) / (6.34 ± 3.08), (11.63 ± 3.32) / (7.46 ± 2.80) and (5.30 ± 2.04) in daytime and night, respectively (12.11 ± 1.99) / (7.95 ± 1.84), (11.97 ± 1.84) / (8.24 ± 1.66), (12.69 ± 2.08) / (4.11 ± 2.40) mmHg /(6.90 ± 1.34) mmHg (P <0.05). However, there was no significant difference between the two groups (P> 0.05). (2) Valley-peak ratio: The SBP of benidipine group and amlodipine group were 65% and 95% respectively; DBP was 62% and 69% respectively. (3) The incidence of adverse reactions: benidipine group was lower than amlodipine group, but there was no significant difference between the two groups. CONCLUSION: Benidipine (4-8mg / d) or amlodipine (5-10mg / d) can maintain stable antihypertensive treatment for 24 hours in patients with essential hypertension once daily oral administration.