不同服药方法对原发性高血压患者降压疗效的影响

发布时间：2019-04-23 23:28

【摘要】：目的:探讨不同服药方法对原发性高血压患者降压疗效的影响。方法:选取规律口服两种及以上长效降压药物、诊室血压140/90mm Hg的高血压患者,完善24h动态血压监测(24h ABPM)后予调整服药方法,由原来的晨起顿服改为分次服用,即晨起服用一种,下午4时至6时服用另一种,或者由原来的分次服调整为晨起顿服,随访观察8周后复查24h动态血压监测(24h ABPM)比较各血压参数。结果:入选并完成研究的原发性高血压(EH)患者60例,平均年龄(64.7±9.4)岁,男性19例(31.7%)。分次服组与顿服组比较,分次服组,24h平均收缩压(24h SBP)(128.15±9.51)mm Hg vs(130.91±10.37)mm Hg,下降了(2.76±10.30)mm Hg,t=2.077,P0.05;白天平均收缩压(d SBP)(129.33±9.92)mm Hg vs(132.36±10.34)mm Hg,降低了(2.97±10.77)mm Hg,t=2.138,P0.05;夜间平均收缩压(n SBP)(118.90±11.96)mm Hg vs(124.12±13.00)mm Hg,降低了(5.22±12.89)mm Hg,t=3.139,P0.05;夜间平均舒张压(n DBP)(66.20±7.39)mm Hg vs(69.24±8.50)mm Hg,降低了(3.04±9.15)mm Hg,t=2.574,P0.05;夜间平均脉压(n PP)[(52.70±10.51)mm Hg vs(55.00±10.57)mm Hg,降低了(2.30±6.46)mm Hg,t=2.758,P0.05。但是,分次服组与顿服组,24h平均舒张压(24h DBP)、24h脉压平均值(24h PP)、白天平均舒张压(d DBP)、白天脉压平均值(d PP)、24h收缩压变异性(24h SSD)、24h舒张压变异性(24h DSD)、24h脉压变异性、白天收缩压变异性(d SSD)、白天舒张压变异性(d DSD)、白天脉压变异性(d PSD)、夜间舒张压变异性(n DSD)、清晨血压平均值(MBP)、清晨血压变异性(MBPSD)、血压晨峰(MBPS),差异均无统计学意义(P0.05)。结论:联合长效降压药物治疗原发性高血压患者,分次服与晨起顿服比较,分次服能有效地降低全天收缩压水平、更有效的降低夜间血压,昼夜血压差值改善利于恢复杓型血压节律。
[Abstract]:Objective: to investigate the effect of different medication methods on the antihypertensive effect in patients with essential hypertension (EH). Methods: the patients with hypertension who took two or more long-acting antihypertensive drugs regularly and the patients with 140/90mm Hg in the clinic were adjusted after 24-hour ambulatory blood pressure monitoring (24-hour ABPM). After 8 weeks of follow-up observation, 24-hour ambulatory blood pressure monitoring (24-hour ABPM) was performed to compare the parameters of blood pressure. The blood pressure parameters were compared by 24-hour ambulatory blood pressure monitoring (24-hour ambulatory blood pressure monitoring) after 8 weeks of follow-up observation. Results: 60 patients with essential hypertension (EH) were enrolled and completed. The mean age was (64.7 卤9.4) years, and 19 cases (31.7%) were male. The mean systolic blood pressure (24 h SBP) (128.15 卤9.51) mm Hg vs (130.91 卤10.37) mm Hg,) decreased by (2.76 卤10.30) mm Hg,t=2.077,P0.05; in the fractionated group compared with the control group. Daytime mean systolic blood pressure (d SBP) (129.33 卤9.92) mm Hg vs (132.36 卤10.34) mm Hg,) decreased by (2.97 卤10.77) mm Hg,t=2.138,P0.05;. Nocturnal mean systolic blood pressure (n SBP) (118.90 卤11.96) mm Hg vs (124.12 卤13.00) mm Hg,) decreased by (5.22 卤12.89) mm Hg,t=3.139,P0.05;. Nocturnal mean diastolic pressure (n DBP) () 66.20 卤7.39) mm Hg vs (69.24 卤8.50) mm Hg, decreased by (3.04 卤9.15) mm Hg,t=2.574,P0.05; The mean nocturnal pulse pressure (n PP) [(52.70 卤10.51) mm Hg vs () 55.00 卤10.57) mm Hg,] decreased by (2.30 卤6.46) mm Hg,t=2.758,P0.05.. However, 24 h mean diastolic blood pressure (24 h DBP), 24 h pulse pressure) (24 h PP), daytime mean diastolic blood pressure (d DBP), daytime mean (d PP), 24 h systolic blood pressure variability (24 h SSD),) was observed in the two groups: 24 h diastolic blood pressure (24 h DBP) and 24 h DBP (24 h SSD),). 24h diastolic pressure variability (24h DSD), 24h pulse pressure variability, daytime systolic blood pressure variability (d SSD), daytime diastolic pressure variability (d DSD), daytime pulse pressure variability (d PSD), nocturnal diastolic pressure variability (n DSD), Morning blood pressure mean (MBP), early morning blood pressure variability (MBPSD), blood pressure morning peak (MBPS), difference was not statistically significant (P0.05). Conclusion: the combination of long-term antihypertensive drugs in the treatment of essential hypertension patients, compared with morning-to-morning treatment, fractional administration can effectively reduce the level of systolic blood pressure throughout the day, more effective to reduce blood pressure at night. The improvement of dipper blood pressure difference is beneficial to the recovery of dipper blood pressure rhythm.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.11

【参考文献】