长效钙离子拮抗剂对血压季节变异的影响  

The influence of long effect calcium channel blockers to the seasonal variability of blood pressure

作　　者：唐琼珍[1] 曹平良[1] 黄北南[1] 卢寅辉[1] 陈早芳[1] 胡杰[1] 刘建萍[1] 樊考林[1] 

机构地区：[1]江西省人民医院干部保健门诊,南昌330006

出　　处：《江西医药》2011年第11期969-973,共5页Jiangxi Medical Journal

摘　　要：目的探讨3种长效钙离子拮抗剂对血压季节变异的影响。方法随机选取150例轻中度原发性高血压患者,将其随机分为非洛地平缓释片(5mg,qd)(F组)、硝苯地平控释片(30mg,qd)(X组)、苯磺酸氨氯地平片(5mg,qd)(A组)治疗组,于同年秋季进入试验。经导入期1个月后,每月测血压2-4次,同时记录当日平均气温。1年后每组按1/3比例随机交叉换药,再同样观察1年。结果 3组患者冬季诊室平均收缩压均显著高于夏季(P均<0.05)。F组(14.2 mmHg)和X组(8.5mmHg)的冬夏差值均显著高于A组(6.1 mmHg)(P均<0.05)。A组冬季诊室血压达标率(66.4%)显著高于F组(48.3%)和X组(51.5%)(P均<0.05)。A组随访间诊室收缩压和舒张压的标准差和变异系数均明显低于F组和X组(均P<0.05)。各组诊室收缩压与日平均气温显著相关(F组r=-0.764,P=0.002;X组r=-0.632,P=0.004;A组r=-0.317,P=0.021)。气温每降低1℃,F组收缩压升高0.65mmHg;X组收缩压升高0.63 mmHg;A组收缩压升高0.29 mmHg。多因素Logistic回归分析显示冬季、日平均气温、冬夏诊室平均收缩压差值是心血管事件的影响因素,标准回归系数分别为0.696、-0.524、0.469。结论苯磺酸氨氯地平片较硝苯地平控释片和非洛地平缓释片更有助于降低血压季节变异,血压更为平稳,冬季血压达标率更高。Objective To explore the influence of three kinds of long effect calcium channel blockers to the seasonal variability of blood pressure.Methods 150 patients with mild-to-moderate essential hypertension were randomly assigned to felodipine extend- ed-release tablet 5mg q.d （group F）, nifedipine controlled-release tablet 30mg q.d （group X）and amlodipine hesylate tablet 5mg q.d （group A） group. All patients entered the study in the same Autumn. After one month washout period,we checked their blood pressure two to four times monthly and recorded the daily mean tempreature contemporarily. One year later, we cross changed the drugs of the three groups by a ratio of 1/3 randomly and examined another year samely. Results The office mean systolic blood pressure of the three groups in winter were significantly higher than in summer（all P〈0.05）, and the changes of the group F（14.2mmHg） and the group X（8.5mmHg）were significantly higher than that of the group A（6.1 mmHg） （all P〈0.05）. The office blood pressure attainment rate of the group A（66.4%） was higher than both the group F（48.3%） and the group X（51.5%） in winter（all P〈0.05）.The standard deviations and coefficients of variation of the visit-to-visit office systolic and diastolic blood pressure were significantly lower in the group A than both the group F and the group X （all P〈0.05） ,respectively. The office systolic blood pressure of each group were significantly collerated with daily mean temperature（the group Fr=-0.764,P=0.002; the group Xr=-0.632, P=0.004; the group At=-0.317, P= 0.021）. A 1~C decline of the daily mean temperature caused SBP rise 0.65 mmHg in the group F, SBP rise 0.63 mmHg in the group X and SBP rise 0.29 mmHg in the group A. Multiple regression analysis showed that influence factors of cadiovascular events were win- ter, daily mean temperature, and the change of office mean systolic blood pressure between in winter and in summer. The correspond- ing standard regression coefficients we

关 键 词：钙离子拮抗剂 血压季节变异性 心血管事件 

分 类 号：R544[医药卫生—心血管疾病]