盐酸乐卡地平片与非洛地平缓释片对轻中度原发性高血压患者血压变异性的影响

发布时间：2018-02-10 01:58

本文关键词： 乐卡地平血压变异性 24小时动态血压家庭自测血压　出处：《南京医科大学》2017年博士论文　论文类型：学位论文

【摘要】：目的:比较盐酸乐卡地平片与非洛地平缓释片对轻中度原发性高血压患者小时间血压变异性以及逐日间血压变异性的影响。方法:此研究是对盐酸乐卡地平片治疗轻中度原发性高血压有效性的多中心、随机、开放、以非洛地平缓释片为平行对照的临床研究(NCT编号:NCT01520285)的再分析。轻-中度原发性高血压患者随机进入乐卡地平组或非洛地平组,接受乐卡地平10mg/d或非洛地平5mg/d治疗,用药共6周。患者在随机化前1周开始每日测量家庭自测血压并记录,要求每天早晨和晚上连续3次测量并记录。在基线和第6周时分别测量24小时动态血压。小时间血压变异性定义为24小时动态血压每小时平均值的标准差。逐日间血压变异性定义为每次访视前1周内家庭自测血压每日血压平均值(6个读数)的标准差。结果:此研究共纳入186名患者(乐卡地平组89例,非洛地平组97例)。治疗6周后,与基线相比,ABPM测得的乐卡地平组与非洛地平组的小时间舒张压变异性均显著降低(P0.05)。6周后,乐卡地平组的舒张压变异性显著低于非洛地平组(P0.05),但是两组校正基线后的舒张压变异性下降值并没有显著性差异(P=0.178)。两组的收缩压及舒张压wSD在治疗后均较基线显著降低,且两组之间没有显著性差异。治疗6周后,HBPM测得的乐卡地平组与非洛地平组的逐日间收缩压SD,逐日间舒张压SD均显著下降,两组之间没有显著性差异,两组校正基线后,逐日间收缩压及舒张压SD的下降值没有显著性差异。在基线和治疗过程中,采用诊室血压、家庭自测血压及24小时动态血压测得的收缩压、舒张压、心率均显著相关。并且在基线时,诊室血压值最高,其次为家庭自测血压,再次为24小时动态血压。结论:盐酸乐卡地平片与非洛地平缓释片均能显著降低轻中度原发性高血压患者的小时间血压变异性以及逐日间血压变异性,且两者降低血压变异性的作用没有显著性差异。乐卡地平片是能有效改善血压变异性的降压药物。
[Abstract]:Objective: to compare the effects of lokadipine hydrochloride and felodipine sustained-release tablets on small time blood pressure variability and daytime blood pressure variability in patients with mild and moderate essential hypertension. Multicenter efficacy in the treatment of mild to moderate essential hypertension, A randomized, open, parallel controlled clinical study with felodipine sustained-release tablets: a reanalysis of NCT No.: NCT01520285. patients with mild to moderate essential hypertension were randomly assigned to either the Lecardipine group or the felodipine group for 10 mg / d or 5 mg / d of felodipine. The patients began to measure and record their blood pressure daily one week before randomization. 24 hours ambulatory blood pressure is measured at baseline and 6 weeks, respectively. Small-time blood pressure variability is defined as the standard deviation of 24 hour mean ambulatory blood pressure per hour. Inter-blood pressure variability was defined as the standard deviation of the average daily blood pressure (6 readings) of family blood pressure measured within one week before each visit. Results: the study included 186 patients (89 patients in the Lecardipine group). After 6 weeks of treatment, the small time diastolic blood pressure variability of Lecardipine group and felodipine group was significantly lower than that of baseline group after 6 weeks of treatment. Diastolic blood pressure variability in Lecardipine group was significantly lower than that in felodipine group (P 0.05), but there was no significant difference in diastolic blood pressure variability between the two groups after correction of baseline. Systolic blood pressure and diastolic blood pressure (wSD) in both groups were significantly lower than baseline after treatment. There was no significant difference between the two groups. After 6 weeks of treatment, the daily systolic blood pressure (SDD) and daytime diastolic blood pressure (SD) of Lecardipine group and felodipine group were significantly decreased, and there was no significant difference between the two groups. There was no significant difference between day to day systolic blood pressure (SBP) and diastolic blood pressure (DBP). During baseline and treatment, systolic and diastolic blood pressure were measured by using diagnostic room blood pressure, home blood pressure and 24 hour ambulatory blood pressure. Heart rate was significantly correlated. At baseline, the blood pressure in the clinic was the highest, followed by self-measured blood pressure in the family. Conclusion: both lokadipine hydrochloride and felodipine sustained-release tablets can significantly reduce the small time blood pressure variability and daily blood pressure variability in patients with mild to moderate essential hypertension. There was no significant difference between the two groups in reducing blood pressure variability. Lecardipine is an effective antihypertensive drug for improving blood pressure variability.
【学位授予单位】：南京医科大学
【学位级别】：博士
【学位授予年份】：2017
【分类号】：R544.11

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