不同时间氨氯地平与复方阿米洛利联合治疗高血压的疗效比较  

Comparison of the anti-hypertensive effects of amlodipine and amiloride complex with different administration strategy in hypertensive subjects

作　　者：贾敏[1,2] 曾敬[1,2] 冉华 唐辉 张骏[1,2] 王旭开[1,2] 王红勇[1,2] 杨成明[1,2] 曾春雨[1,2] 

机构地区：[1]第三军医大学大坪医院(野战外科研究所)心血管病专科医院心血管内科,重庆400042 [2]重庆市心血管病研究所 [3]重庆市黔江中心医院心内科 [4]重庆市双桥区医院内科

出　　处：《中华高血压杂志》2011年第1期52-56,共5页Chinese Journal of Hypertension

基　　金：国家杰出青年科学基金(30925018);重庆市杰出青年科学基金(CSTC2009BA5044)

摘　　要：目的观察不同时间联合应用"氨氯地平+复方阿米洛利"对血压、晨峰现象、血压模式影响及对心、肾靶器官的保护作用。方法于2008-03-2009-06选取重庆大坪医院、重庆黔江中心医院、重庆双桥区医院的高血压患者80例,随机分为两组:早上服药组(n=40)和睡前服药组(n=40),分别于8:00和22:00服用氨氯地平5mg及复方阿米洛利半片,连续服药12周。于服药前及12周末进行动态血压检测,分析不同时间给药对血压、晨峰现象、血压模式的影响。结果早上服药、睡前服药两组患者降压总有效率均达97.5%。但与早上服药组相比,睡前服药组患者血压晨峰现象缓解,夜间血压下降率[服药后收缩压:(13.2±3.3)比(9.9±3.6)%;服药后舒张压:(13.9±3.8)比(10.5±3.2)%]明显增加,高血压患者异常的血压昼夜节律明显改善甚至恢复正常。结论不同时间服用"氨氯地平+复方阿米洛利"降血压效果存在差别,夜晚服药较清晨服药对缓解血压晨峰现象、改善异常的血压昼夜节律有明显的优势。Objective To observe the different effect of amlodipine and amiloride complex with different time-administration on blood pressure,blood pressure pattern,morning surge and the protective effect on heart and kidney.Methods Eighty patients were included in this study.Subjects were randomly assigned to receive medicines in the morning or at bedtime.Profiles,including blood pressure,blood pressure pattern,morning surge and the protective effect on heart and kidney,were recorded before and after treatment for 12 weeks.Results Total effective rate of those medicines was about 97.5% in both groups.However,as compared with morning group,the morning surge of blood pressure was alleviated to a greater degree;the nocturnal blood pressure and 24 h mean blood pressure were lower,and more hypertensive converted from non-dipper to dipper blood pressure in the bedtime group.Conclusions Amlodipine and amiloride complex has different efficiency depending on the treatment time.Administration at bedtime could optimize the anti-hypertensive effect by augmented the blood pressure-lowering effects,increasing the diurnal/nocturnal ratio of blood pressure,normalizing the blood pressure pattern and alleviating the morning surge.

关 键 词：原发性高血压 时间治疗学 氨氯地平 复方阿米洛利 

分 类 号：R544.1[医药卫生—心血管疾病]