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[目的]评价拉西地平联合缓释型硝苯啶治疗高血压的临床疗效。[方法]选择本院入院高血压病人共158人,随机分为缓释型硝苯啶组78名和拉西地平联合缓释型硝苯啶组80名。治疗6个月,收集病人的舒张压(DBP)、收缩压(SBP)、心率、肱动脉充血后内径变化率(FMD)、舒张末期颈总动脉内中层厚度(IMTcca)、冠状动脉分叉中层厚度(IMTbif)、颈内动脉中层厚度(IMTica)、舒张末室间隔厚度(LVST)、左室后壁厚度(LVPWT)、左室舒张末内径(LVID)、左室质量指数(LVMI)、超敏C反应蛋白(hs-CRP),并比较两组差异。[结果]临床试验显示,拉西地平联用组平均收缩压由给药前的159.4mmHg降至127.1mmHg,平均舒张压由99.7mmHg降至78.4mmHg(P﹤0.05)。拉西地平联用组的3个IMT,即IMTcca、IMTbif、IMTica和给药前比均有不同程度的降低(P﹤0.05),而缓释型硝苯啶组以上3个指标有降低趋势,但差异无统计学意义(P﹥0.05)。与缓释型硝苯啶组比,拉西地平联用组的PWTD、LVID、LVMI均有明显改善(P﹤0.05),hs-CRP显著降低(P﹤0.05)。[结论]拉西地平联用组具有显著地降低血压,增加心脏容量,并同时减轻左室肥厚,减少高血压病人炎症的作用。
[Objective] To evaluate the clinical efficacy of lacidipine combined with extended-release nifedipine in the treatment of hypertension. [Method] A total of 158 hypertensive patients admitted to our hospital were randomly divided into the controlled release nifedipine group (n = 78) and lacidipine combined sustained release nifedipine group (n = 80). After 6 months of treatment, the diastolic blood pressure (DBP), systolic blood pressure (SBP), heart rate, rate of change of internal diameter after brachial artery hyperemia (FMD), end-diastolic common carotid artery IMTcca, (IMTbif), IMTica, LVST, LVPWT, LVID, LVMI, Sensitive C-reactive protein (hs-CRP), and compare the two groups differences. [Results] The clinical trial showed that the average systolic blood pressure of lacidipine group decreased from 159.4 mmHg to 127.1 mmHg and the average diastolic blood pressure decreased from 99.7 mmHg to 78.4 mmHg (P <0.05). The three IMTs of lacidipine combined group (IMTcca, IMTbif, IMTica, and pretreatment) all had different degrees of reduction (P <0.05), while the three indexes of the sustained release nifedipine group tended to decrease, But the difference was not statistically significant (P> 0.05). Compared with the sustained-release nifedipine group, the PWTD, LVID and LVMI of lacidipine group were significantly improved (P <0.05) and hs-CRP was significantly decreased (P <0.05). [Conclusion] The combination of lacidipine and rhGiLi can significantly reduce blood pressure, increase cardiac volume, relieve left ventricular hypertrophy and reduce inflammation in hypertensive patients.