动态血压评价不同时间服用氨氯地平的降压效应  

Effect of 24 h Blood Pressure by Amlodipine Administered in \;Different Time

作　　者：邱原刚[1] 郑萍 姚雪艳[1] 何俊玲[1] 胡晓晟[1] 陈君柱[1] 朱建华[1] 

机构地区：[1]浙江大学医学院附属第一医院心内科 [2]浙江医学职业技术学院,浙江杭州310003

出　　处：《高血压杂志》2000年第3期207-209,共3页Chinese Journal of Hypertension

摘　　要：目的 :研究服药时间对氨氯地平降压效应的影响。方法 :采用随机、开放、自身对照的研究方法。高血压患者经二周安慰剂导入期 ,服安慰剂末诊室血压在 95～ 1 1 5 mm Hg者入选 ,随机于 7:0 0或 2 1 :0 0予 5 mg氨氯地平治疗 ,二周后降压不满意者加至 1 0 mg,服用氨氯地平六周后 ,交换服药时间再服六周。服安慰剂末、早晨给药六周、睡前给药六周后分别行动态血压监测 ,分析其 T/ P、收缩压峰值、舒张压峰值、夜间收缩压和舒张压下降值、夜间收缩压和舒张压下降百分率 ,以及 2 4小时、白天及夜间的平均收缩压、平均舒张压、收缩压负荷、舒张压负荷和心率。结果 :二服药组总有效率为 1 0 0 % ,收缩压、舒张压的 T/ P均大于 6 0 % ,各平均收缩压、平均舒张压、收缩压负荷、舒张压负荷均较服药前明显降低 (P<0 .0 1 )。二服药组之间比较 ,各诊室血压及动态血压指标均无显著性差异。夜间收缩压、舒张压的下降值和下降百分率、平均心率指标三组之间无显著性差异。结论 :早晨或睡前服药均能有效控制 2 4小时血压 。Objective:To assess the impact of timing administration of amlodipine on antihypertensive effect of amlodipine. Methods:Thirty one outpatients with mild to moderate hypertension after two weeks placebo were randomly received 5 mg amlodipine at 7:00 or at 21:00. Clinic sitting position blood pressure was measured every two weeks. If diastolic blood pressure was not reduced to normal level at 2 weeks of therapy, the dose was increased to 10 mg. After 6 weeks, the time of drug administration was crossed over. Ambulatory blood pressure monitoring(ABPM) was performed after two weeks of placebo, sixth weeks of morning time administration and sixth weeks of night time administration. Results:Clinic blood pressure was lower under both regimes( P< 0 01). Twenty four hour mean, daytime and night time mean, twenty four hour BP load, daytime and night time BP loads, twenty four hour BP peak value were lower under both doses than they were with placebo with little differences. Nocturnal fall of SBP and DBP percentage,daytime and night time HR means did not differ in ABPM. Conclusions:Both morning time and night time administration of amlodipine can control 24 hour blood pressure effectively. This study indicates that timing of administration does not influence the antihypertensive effect of amlodipine.

关 键 词：氨氯地平 高血压 时间治疗学 

分 类 号：R544.1[医药卫生—心血管疾病]