不同时间联合使用非洛地平和替米沙坦对高血压患者血压昼夜节律的影响及对左室肥厚的逆转作用  

Effects of combination therapy with felodipine plus telmisartan in different time on circadian blood pressure rhythms and cardiac remodeling in patients with essential hypertension

作　　者：向兰汀 刘明瑜 刘钊 

机构地区：[1]武汉市青山区第一医院心内科,武汉430080

出　　处：《临床心血管病杂志》2008年第10期734-737,共4页Journal of Clinical Cardiology

摘　　要：目的:研究不同时间联合使用非洛地平和替米沙坦对高血压患者血压昼夜节律的影响及对高血压左室肥厚的逆转作用。方法:将入选的86例高血压并发左室肥厚的患者随机分为2组,A组清晨顿服非洛地平和替米沙坦,B组清晨服用非洛地平,晚间服用替米沙坦,服药前及服药后每隔4周时分别测定患者诊室血压和24 h动态血压,测定用药前及用药36周时舒张期室间隔厚度(LVST),左室后壁厚度(LPWT)及舒张期左室内径(LVDd),并计算出心室重量(LVMT)。结果:2组用药后各时点收缩压及舒张压均低于用药前。B组夜间平均收缩压、夜间平均舒张压、晨峰血压升高程度、清晨收缩压、清晨舒张压、清晨脉压均较A组低。并且治疗36周后,B组的LVDd,LVST,LPWT均较A组减小(P<0.05)。结论:不同时间联合使用非洛地平和替米沙坦比清晨同时联合使用非洛地平和替米沙坦更能降低夜间血压、遏制清晨血压过度升高,改善高血压患者血压昼夜节律,并且在逆转左室肥厚方面,更有优势。Objective： To study the effects of combination therapy with felodipine plus telmisatan in different time on circadian blood pressure rhythms and cardiac remodeling in patients with essential hypertension. Method： Eighty six cases of hypertensive patients with left ventricular hypertrophy were randomly divided into two groups. Group A was treated with a draught of felodipine and telmisartan in the early morning, and group B was treated with felodipine in the early morning and telmisartan in the evening respectively. The office blood pressure and 24- hour ambulatory blood pressure were determinated before and 4 weeks after treatment. LVST,LPWT and LVDd were determinated before and 36 weeks after treatment. And LVM, LVMI were calculated. Result： After combination treatment, systolic blood pressure and diastolic blood pressure were lower than before in both group A and group B. In group B with divided time combination medication, the average night systolic pressure, average night diastolic pressure, the early morning peak blood pressure elevation, early morning systolic pressure, early morning diastolic pressure and early morning pulse pressure were lower than in group A. Values of LVDd, LVST and LP WT in group B were less than these in group A （P〈0. 05）. Conclusion：Combination use of felodipine and telmisartan in different time enable night blood pressure lower, an excess of early morning blood pressure rising restrained better than combination use simultaneously in early morning and circadian blood pressure rhythms of the patients with hypertension improved. And the combination therapy in group B has more advantages on reversing left ventrieular hypertrophy.

关 键 词：非洛地平 替米沙坦 动态血压 左室肥厚 

分 类 号：R972[医药卫生—药品]