盐酸阿罗洛尔治疗杓型及非杓型原发性高血压的临床研究  

Clinical trial of arotinolol in essential hypertension treatment: dippers vs non-dippers

作　　者：黄建凤[1] 张宇清[1] 吴海英[1] 刘国仗[1] 孙宁玲[2] 余振球[3] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院,北京市100037 [2]北京大学人民医院,北京市100044 [3]北京安贞医院,北京市100029

出　　处：《中华老年多器官疾病杂志》2004年第2期100-103,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的　观察盐酸阿罗洛尔对杓型及非杓型原发性高血压患者的 2 4h动态血压的影响。方法　选择符合入选条件的 1～ 2级原发性高血压患者 4 7例。平均年龄 (4 9.6± 7.8)岁 (18～ 70岁 )。服用安慰剂 1周后 ,测量2 4h动态血压 ,根据夜间血压下降程度将患者分为杓型组和非杓型组 ,其中杓型组 2 3例 ,非杓型组 2 4例。所有患者给予盐酸阿罗洛尔治疗 ,每次 10～ 15mg ,2次 /d ,连续 4～ 6周 ,治疗结束时再测量一次 2 4h动态血压。结果　治疗 4周后两组偶测血压均较治疗前有显著降低 ,杓型组的治疗总有效率为 78.2 % ,非杓型组为 5 4 .2 % ;动态血压各项指标 :2 4h平均收缩压 (2 4hMSBP)、2 4h平均舒张压 (2 4hMDBP) ,白天平均收缩压 (dMSBP)、白天平均舒张压(dMDBP)和血压负荷均有显著降低 ,同时全天的心率也较治疗前明显下降 ;治疗后 ,非杓型组 2 4例患者中 ,有 12例(5 0 % )血压节律改变为杓型。结论　盐酸阿罗洛尔是一种有效的抗高血压药物 ,在影响血压节律方面 ,能够更显著地降低非杓型患者的夜间血压水平。Objective To compare the efficacy of an α,β blocker, arotinolol, in the treatment of essential hypertension between patients with a dipper and those with a non-dipper profile by means of 24 h ambulatory blood pressure monitoring (ABPM). Methods A multicenter single blind parallel trial was carried out in five clinical centers. After a one-week single blind placebo run-in period, patients underwent ABPM measurement if their clinical diastolic blood pressure (DBP) ranged from 90-109 mmHg and their clinical systolic blood pressure (SBP) was <180 mmHg. A total of 47 patients at ages 49.6±7.8 were divided into two groups according to the absence (non-dipper group, 24 cases) or presence (dipper group, 23 cases) of nocturnal BP reduction ≥10% of daytime BP. ABPM was carried out again at the end of the active treatment phase. All patients were given arotinolol 10-15 mg twice daily for 4 weeks. Results Twenty four-hour systolic and diastolic average blood pressures (MSBP, MDBP), 24 h systolic and diastolic blood pressure load (LSBP, LDBP), daytime systolic and diastolic average blood pressures (dMSBP, dMDBP), daytime systolic and diastolic blood pressure load (dLSBP, dLDBP), nighttime systolic and diastolic average blood pressures (nMSBP, nMDBP) and nighttime systolic and diastolic blood pressure load (nLSBP, nLDBP) were calculated. Arotinolol was effective in 78.2% of dippers and 54.2% of non-dippers, but the difference in effectiveness between these two groups was not statistically significant. After treatment, SBP and DBP, including 24 h and daytime systolic and diastolic blood pressures, were significantly reduced in both groups. During the nighttime period, only diastolic blood pressure was significantly reduced, while the systolic blood pressure had no significant change in both groups. Conclusions Arotinolol, which can be dosed twice daily, is an effective antihypertensive agent which effectively lowers blood pressure during the day, while it only reduces nighttime diastolic blood pressure, but not n

关 键 词：盐酸阿罗洛尔 杓型原发性高血压 非杓型原发性高血压 血压节律 抗高血压药 

分 类 号：R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]