目的 探討硝苯地平聯(lián)合貝那普利治療老年高血壓的臨床療效。方法 選取2015年4月—2015年12月在天津市河西區(qū)康復(fù)醫(yī)院就診的老年高血壓患者86例，隨機(jī)分為對照組和治療組，每組各43例。對照組患者口服鹽酸貝那普利片，10 mg/次，1次/d，根據(jù)血壓情況劑量加至20~40 mg/d。治療組患者在對照組的基礎(chǔ)上口服硝苯地平控釋片，30 mg/次，1次/d。兩組患者均連續(xù)治療6周。觀察并比較兩組患者臨床療效、內(nèi)皮舒張功能、內(nèi)皮分泌功能和動(dòng)脈血壓變化。結(jié)果 治療后，對照組的總有效率為79.07%，顯著低于治療組的93.02%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組患者24 h平均舒張壓（24 h DBP）、24 h平均收縮壓（24 h SBP）、白天平均舒張壓（dDBP）、白天平均收縮壓（dSBP）、晚上平均舒張壓（nDBP）、晚上平均收縮壓（nSBP）和收縮壓的晝夜變異率（BPF）均顯著下降（P < 0.05）；且治療組患者動(dòng)脈血壓改善優(yōu)于對照組（P < 0.05）。治療后，兩組患者肱動(dòng)脈內(nèi)徑變化率（FMD）均顯著升高（P < 0.05）；且治療后治療組患者FMD顯著高于對照組（P < 0.05）。治療后，兩組患者血清NO水平顯著上升，內(nèi)皮素（ET）和神經(jīng)肽Y（NPY）水平顯著下降，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組患者NO、ET和NPY水平顯著優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）。結(jié)論 硝苯地平控釋片聯(lián)合貝那普利治療老年高血壓，可以降低血壓變異性，改善血管內(nèi)皮功能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of nifedipine combined with benazepril in treatment of elderly hypertension. Methods Patients (86 cases) with hypertension in Rehabilitation Hospital of Hexi District in Tianjin City from April 2015 to December 2015 were randomly divided into control and treatment groups, each group had 43 cases. Patients in the control group were po administered with Benazepril Hydrochloride Tablets, 10 mg/time, once daily, and the dosage was increased to 20 — 40 mg/d according to blood pressure conditions. Patients in the treatment group were po administered with Nifedipine Controlled-release Tablets on the basis of the control group, 30 mg/time once daily. Patients in two groups were treated for six weeks. After treatment, the clinical efficacy, endothelial dilation function, endothelial secretion function, and arterial blood pressure change in two groups before and after treatment were observed and compared. Results After treatment, the clinical efficacy in the control group was 79.07%, which was significantly lower than 93.02% in the treatment group, with significant difference between two groups (P < 0.05). After treatment, the 24 h SBP, dSBP, nSBP, 24 h DBP, dDBP, nDBP, and BPF in two groups significantly decreased (P < 0.05). And the arterial blood pressure change in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the FMD in two groups significantly increased (P < 0.05). And FMD in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the serum NO level in two groups significantly increased, ET and NPY levels significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the NO, ET, and NPY levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Nifedipine combined with benazepril can decrease blood pressure variability and improve vascular endothelial function in treatment of elderly hypertension, which has a certain clinical application value.