【摘要】：目的探討晨起或睡前應(yīng)用纈沙坦氫氯噻嗪片對非杓型高血壓患者降壓及逆轉(zhuǎn)非杓型高血壓的效果。方法納入74例1~2級非杓型高血壓患者,隨機(jī)分為晨起服藥組和睡前服藥組,分別在晨起或睡前服用纈沙坦氫氯噻嗪片(每片含纈沙坦80 mg及氫氯噻嗪12.5 mg),所有病例治療前及治療12周后進(jìn)行動(dòng)態(tài)血壓監(jiān)測。結(jié)果兩組患者治療后全天各時(shí)段血壓較治療前均顯著降低(P0.01);治療后兩組間全天及日間平均收縮壓、舒張壓及血壓變異性無顯著差異(P0.05);睡前服藥組夜間平均收縮壓及舒張壓顯著低于晨起服藥組(P0.05);治療12周后睡前服藥組夜間血壓降幅較晨起服藥組更顯著(P0.01);研究結(jié)束時(shí),睡前服藥組的逆轉(zhuǎn)率顯著高于晨起服藥組[51%(18/35)vs.8%(3/36),P0.01]。結(jié)論晨起和睡前服用纈沙坦氫氯噻嗪片均能夠明顯降低非杓型原發(fā)性高血壓患者全天血壓;睡前服藥能顯著降低夜間血壓水平,糾正異常血壓節(jié)律。
[Abstract]:Objective to investigate the effect of valsartan hydrochlorothiazide tablets on lowering blood pressure and reversing non-dipper hypertension in patients with non-dipper hypertension. Methods 74 patients with grade 1 or 2 non dipper hypertension were randomly divided into morning medication group and bedtime medication group. They were treated with valsartan hydrochlorothiazide tablets (each tablet containing valsartan 80 mg and hydrochlorothiazide 12.5 mg),) in the morning or before bedtime. Ambulatory blood pressure monitoring was performed in all patients before treatment and 12 weeks after treatment. Results the blood pressure of the two groups was significantly lower than that before treatment (P0.01), and there was no significant difference in the mean systolic blood pressure, diastolic blood pressure and blood pressure variability between the two groups after treatment (P0.05). The nocturnal mean systolic and diastolic blood pressure were significantly lower in the pre-bedtime group than in the morning group (P0.05), and the nocturnal blood pressure decreased significantly in the pre-bedtime medication group after 12 weeks (P0.01). At the end of the study, the reversal rate was significantly higher in the bedtime group than in the morning group [51% (18 / 35) vs.8% (3 / 36), P0.01]. Conclusion taking valsartan hydrochlorothiazide tablets in the morning and before bedtime can significantly reduce the whole day blood pressure in patients with non-dipper essential hypertension, and before bedtime administration can significantly reduce the level of blood pressure at night and correct abnormal blood pressure rhythm.
【作者單位】： 河北省人民醫(yī)院心臟中心;河北省人民醫(yī)院內(nèi)分泌科;
【分類號】：R544.1

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