动态血压监测评估不同时间联合用药对合并糖尿病高血压患者的降压效果.docVIP

精品论文 参考文献 动态血压监测评估不同时间联合用药对合并糖尿病高血压患者的降压效果 遇波1 付桂华1 盖咏梅2 牧坤1 苏静1 杨桂云1 刘研1 刘敬红1 　　（1哈尔滨医科大学第五附属医院高干病房 黑龙江 大庆 163000） 　　（2大庆市第二人民医院 黑龙江 大庆 163000） 　　【摘要】 目的：观察不同时间联合用药对合并糖尿病高血压患者的降压疗效和血压变异的影响。方法：96例合并糖尿病高血压患者随机分为早晨顿服缬沙坦胶囊和苯磺酸氨氯地平片(A组,23例)、晨服缬沙坦胶囊和晚服苯磺酸氨氯地平片(B组,24例)、晨服苯磺酸氨氯地平片和晚服缬沙坦胶囊 (C组,22例)和晚上顿服缬沙坦胶囊和苯磺酸氨氯地平片(D组,24例)。夜间服药均与睡前2-3h前。服药前及服药后4周均用动态血压仪监测。结果：各组服药前后比较，收缩压/舒张压差异均有统计学意义（Plt;0.01）。治疗后四组24小时收缩压/舒张压下降值26.0/20.8mmHg、24.0/23.9mmHg、23.8/20.4mmHg及28.2/24.6mmHg。组间比较，夜间平均收缩压下降值D组与A、B、C三组比较差异有统计学意义（Plt;0.05）。D组治疗后晨峰血压增高例数较治疗前减低（Plt;0.05），A、B、C三组治疗前后晨峰血压分布差异无统计学意义（Pgt;0.05）。四组间24h收缩压/舒张压下降值及平滑指数比较差异无统计学意义（Pgt;0.05）。结论：联合用药降压效果下显著，夜间顿服能更有效地控制夜间血压，有血压变异较少的趋势，能更好的控制晨峰血压，且无夜间低血压发生率增加。 　　【关键词】 糖尿病合并高血压；时间治疗学；治疗结果 　　【中图分类号】R587.1 【文献标识码】A 【文章编号】2095-1752（2015）06-0073-03 　　Impact of antihypertensive medication timing on degree of blood pressure lowering in patients with essential hypertension and Type-II Diabetes 　　YU Bo, FU Gui-hua, GAI yong-mei SHI Mu-mu, MU kun, YANG gui-yun, SU Jing 　　【Abstract】 Objective To observe the effects of antihypertensive medication timing on degree of blood pressure lowering in patients with essential hypertension and Type-II Diabetes. Methods ninety-four patients were randomly assigned to take valsartan and amlodipine together in morning(group A 23 cases), valsartan in the morning and amlodipine in the evening(group B 24 cases), amlodipine in the morning and valsartan in the evening(group C 22 cases), valsartan and amlodipine together in evening(group D 24 cases). ABPM was performed before and after 4 weeks treatment. Results BP was significantly reduced in 4 groups (Plt; 0.05). The BP reductions during nighttime and morning blood pressure surge after treatment in group D was significant more than those in group other groups (Plt; 0.05). SI of 24 hours SBP/DBP were similar among groups at both baseline and after various treatment regimens (P gt;0.05). Conclusion There is a trend in better BP