监测48小时动态血压评估替米沙坦对轻、中度原发性高血压的疗效  

Effects of telmisartan on mild to moderate essential hypertension assessed by 48 h ambulatory blood pressure monitoring

作　　者：李华[1] 张博恒[2] 初少莉[1] 郭冀珍[1] 诸骏仁[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院高血压科,上海200025 [2]复旦大学附属中山医院,上海200032

出　　处：《中国新药与临床杂志》2010年第1期50-53,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的观察替米沙坦48h血压控制的效果和对动脉硬化指数(AASI)的影响。方法轻、中度原发性高血压患者71例,经过2wk的清洗期后接受口服替米沙坦,80mg,qd,治疗8wk。治疗前接受24h动态血压监测,治疗8wk后接受48h动态血压监测,比较治疗前后血压以及AASI的变化。结果完成有效病例数60例。治疗8wk时,末次服药后d1的平均SBP和DBP分别为(134±s14)mmHg、(87±8)mmHg,末次服药后d2的平均SBP和DBP分别为(135±14)mmHg、(88±8)mmHg,均比治疗前[(141±14)mmHg、(92±8)mmHg]显著下降(P<0.01);治疗的总有效率为60%(36/60),末次服药后d2有效率仍达50%(30/60)。对治疗有效的病例进行分析:SBP和DBP下降的平滑指数(SI)分别为1.02和0.89;清晨高血压患者的比例治疗前69%(25/36),治疗后下降至39%(14/36)(P<0.01),而所有患者夜间平均DBP均在60mmHg以上。治疗后AASI有下降趋势,但无显著差异(0.48±0.15vs.0.44±0.18,P>0.05),AASI的变化与脉压的改变密切相关。结论替米沙坦80mg能够持续48h控制轻、中度原发性高血压,降低清晨高血压,夜间血压无过度下降,对AASI的影响尚需进一步随访观察。AIM To observe the antihypertensive effect of telmisartan and its influence on ambulatory arterial stiffness index （AASI） in mild to moderate essential hypertension by 48 h ambulatory blood pressure monitoring （ABPM）.METHODS After a 2-week wash out period,71 patients with mild to moderate essential hypertension received telmisartan 80 mg once daily for 8 weeks.Twenty-four h ABPM was performed before treatment,and 48 h ABPM was performed after the 8-week treatment.The change of blood pressure and AASI were analyzed.RESULTS A total of 60 valid patients with complete trial enrolled the analysis.After a 8-week treatment,average SBP /DBP after the medication were significantly lower than baseline,either in d 1 （（134 ±s 14） mmHg /（87 ± 8） mmHg vs.（141 ± 14） mmHg /（92 ± 8） mmHg,P 0.01） or in d 2 （（135 ± 14） mmHg /（88 ± 8） mmHg vs.（141 ± 14） mmHg /（92 ± 8） mmHg,P 0.01）.Total effective rate was 60% （36 /60） in d 1 and still reached 50% （30 /60） in d 2.In patients with effective treatment,smoothness index （SI） of SBP and DBP reduction were 1.02 and 0.89.While the proportion of patients with early morning hypertension significantly reduced from 69% （25/36） to 57% （14/36） （P 0.01）,the average nocturnal DBP of all patients were higher than 60 mmHg.AASI showed a downward trend,but no statistically significant difference （0.48 ± 0.15 vs.0.44 ± 0.18,P 0.05）,AASI reduction was closely related to the change of pulse pressure.CONCLUSION Telmisartan 80 mg once daily could provides sustained BP control over 48 h dosing period for mild to moderate hypertension,reduce early morning blood pressure effectively and without excessive decline of nocturnal blood pressure.The effect on AASI need further follow-up.

关 键 词：替米沙坦 血压监测 便携式 高血压 治疗结果 

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