摘要
目的:探讨如何获得24小时平稳降压。方法:采用平行对照设计,将90例2级或以上原发性高血压患者分为3组。A组30例,早晨服用硝苯地平控释片和替米沙坦;B组早晨服用替米沙坦,晚上服用硝苯地平控释片;C组早晨服用硝苯地平控释片,晚上服用替米沙坦。服药前2周进行动态血压监测,获得24小时平均收缩压(24hSBP)、24小时平均舒张压(24hDBP)、平滑指数(SI)等指标。结果:服药2周后,各组夜间及24小时的平均收缩压下降为:19.1mmHg、28.6mmHg、30.3mmHg、22.6mmHg、27.9mmHg及28.7mmHg(1mmHg=0.133kPa)。三组比较,A组<B组(P<0.01),A组<C组(P<0.01)。各组夜间及24小时平均动脉压的下降值依次为16.6mmHg、17.9mmHg、20.4mm-Hg、16.8mmHg、18.9mmHg、及19.6mmHg。组间比较,以上各值A组与B组、A组与C组比较差异有统计学意义;而B组与C组数值上虽有差异,但无统计学意义(P>0.05)。夜间及24小时平均收缩压平滑指数各组依次为2.41、3.10、3.20及1.89、2.47、2.24,组间比较,夜间平均收缩压平滑指数A组<B组(P<0.01),A组<C组(P<0.01);24小时平均收缩压平滑指数A组<C组(P<0.01),A组<B组(P<0.01);夜间及24小时平均动脉压平滑指数依次为4.18、4.71、4.87、2.66、3.05及3.23。组间比较A组<B组(P<0.05),A组<C组(P<0.01)。夜间舒张压平滑指数分别为2.50、3.64、3.10,组间比较A组<B组(P<0.01),A组<C组(P<0.05),以上各值A组与B组、A组与C组比较差异均有统计学意义,B组与C组比较差异无统计学意义(P>0.05)。结论:联合用药治疗效果更佳,早晚分次服药较早晨顿服两种药物能更平稳降压,有效控制夜间血压,使夜间及24h血压下降更平稳。
Objective：To explore how to get 24 hours of steady lowering of blood pressure.Methods：90 patients were assigned to take Telmisartan and Nifedipine controlled relesse tablets together in the morning（groupe A）,Telmisartan in the morning and Nifedipine controlled relesse tablets in the evening（group B） or Nifedipine controlled relesse tablets in the morning and Telmisartan in the evening（group C）.Medicine dynamic blood pressure monitoring in the two weeks before taking the medicine,got 24hSBP,24hDBP,SI index.Results：The blood pressure reductions during night-time and twenty-four hours in group B and C were similar（P〉0.05）,but there were more differences than those in group A（P〈0.05）.The smoothness indexes of mean systolic,mean arterial blood pressure during night-time and twenty-four hours in group B and C were similar,but significantly higher than that in group A（P〈0.05）.The smoothness index of diastolic pressure at nighttime in group B and C was similar,but significantly higher than that in group A（P〈0.05）.Conclusion：The effect of combined medication is better,medications separately in the morning and at evening compared with taking the two drugs together in the morning,can more smoothly reduce blood pressure.
出处
《中国民康医学》
2012年第14期1665-1667,1672,共4页
Medical Journal of Chinese People’s Health
关键词
服药方法
高血压
Medication method
Hypertension
