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[目的]研究氨氯地平联合培哚普利对老年高血压患者心率变异性(heart rate variability,HRV)及颈动脉内膜中层厚度(intima-media thickness IMT)的影响。[方法]收集2008年1月~2009年12月在我科住院的老年高血压患者90例,随机分为氨氯地平组、培哚普利组和氨氯地平联合培哚普利组。各组治疗前及治疗24周后行24 h动态血压检测(24-hour ambulatory blood pressure ABP)、HRV分析及颈动脉IMT测定,结果进行统计学分析。[结果]各组治疗后血压均明显下降(P﹤0.05)。氨氯地平组治疗后颈动脉IMT减少(P﹤0.05),但HRV无明显差异(P﹥0.05)。培哚普利组治疗后颈动脉IMT无明显变化(P﹥0.05),但HRV显著升高(P﹤0.01)。氨氯地平联合培哚普利组治疗后颈动脉IMT减少(P﹤0.05),同时HRV显著升高(P﹤0.01)。[结论]氨氯地平及培哚普利对老年高血压患者降压疗效相似。氨氯地平能减少颈动脉IMT,培哚普利能提高HRV,两药联合应用能使老年高血压患者在降压同时获益更多。
[Objective] To investigate the effect of amlodipine combined with perindopril on heart rate variability (HRV) and carotid artery intima-media thickness (IMT) in elderly patients with hypertension. [Methods] 90 elderly hypertensive patients hospitalized in our department from January 2008 to December 2009 were randomly divided into amlodipine group, perindopril group and amlodipine combined with perindopril group. The 24-hour ambulatory blood pressure (ABP), HRV and carotid IMT were measured before treatment and 24 weeks after treatment. The results were statistically analyzed. [Results] After treatment, the blood pressure decreased significantly in each group (P <0.05). After amlodipine treatment, carotid IMT decreased (P <0.05), but no significant difference in HRV (P> 0.05). There was no significant change in carotid IMT after perindopril treatment (P> 0.05), but HRV was significantly increased (P <0.01). After treatment with amlodipine and perindopril, carotid IMT decreased (P <0.05) and HRV increased significantly (P <0.01). [Conclusion] Amlodipine and perindopril have similar effects on antihypertensive effect in elderly patients with hypertension. Amlodipine can reduce carotid IMT, perindopril can improve HRV, the combination of the two drugs can make hypertension in elderly patients benefit more at the same time.