小剂量左氨氯地平、替米沙坦及氢氯噻嗪同时或不同时给药降压及逆转非杓型高血压的临床分析  

Efficacy of small dosed levamlodipine, telmisartan and hydrochlorothiazide given at the same or different time points on anti-hypertension and reverse of non-dipper hypertension： clinical analysis of 300 cases

作　　者：英俊岐[1] 高春燕[1] 侯丽萍[1] 娄满[1] 陈丽曼[1] 胡晓英[1] 

机构地区：[1]河北医科大学附属哈励逊国际和平医院老年病一科,衡水053000

出　　处：《中华老年多器官疾病杂志》2014年第7期520-523,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：河北省科技支撑计划项目（13277761D）;河北省衡水市科技与研究发展项目（12004A）

摘　　要：目的探讨小剂量左氨氯地平、替米沙坦及氢氯噻嗪同时或不同时给药降压及逆转非杓型血压的效果。方法选择300例收缩压（SBP）〈180mmHg，舒张压（DBP）91～109mmHg，年龄〉45岁的非杓型高血压患者，随机分为两组，I组（不同时给药组）晨服替米沙坦40mg和氢氯噻嗪10mg，晚服左氨氯地平2．5mg；Ⅱ组（同时给药组）以上3种药物均晨服，所有病例治疗前及治疗8周后进行动态血压监测。结果（1）治疗8周后，I组和Ⅱ组的24hSBP／DBP分别降低14．92／9．96和15．04／10．66mmHg，日间SBP／DBP分别降低13．90／10．60和16．06／11．70mmHg，均较治疗前明显降低（P〈0．01）；两组24h和日间SBP／DBP治疗后差异无统计学意义（P〉0．05）。（2）I组夜间SBP／DBP降低25．44／19．48mmHg，与治疗前相比差异非常显著（P〈0．01）。（3）Ⅱ组夜间SBP／DBP降低17．68／14．76mmHg，与治疗前差异也有统计学意义（P〈0．05）。（4）治疗后夜间SBP／DBP降幅I组较Ⅱ组差异更明显（P〈0．01）。（5）I组逆转率为88．16％，Ⅱ组为55．41％，两组比较差异有统计学意义（P〈0．01）。结论小剂量左氨氯地平、替米沙坦及氢氯噻嗪两种服药方法均能有效地控制24h血压和日间血压，而不同时给药能更好地逆转非杓型高血压。Objective To determine the efficacy of small doses of levamlodipine, telmisartan and hydrochlorothiazide given at the same or different time points on anti-hypertension and reverse of non dipper hypertension. Methods Three hundred over-45-year-old patients with non-dipper hypertension [systolic blood pressure （SBP） 〈 180mmHg and diastolic blood pressure （DBP） ranging from 90 to 109mmHg）] admitted in our out- and in-patient departments from May 2011 to October 2013 were prospectively subjected in this study. They were randomly divided into 2 groups, group I （the drugs were given at different time, 40mg telmisartan and 10mg hydrochlorothiazide were given in the morning, while 2.5mg levamlodipine at night）, and group Ⅱ （all 3 drugs were given at the morning）. All cases received ambulatory blood pressure monitoring before and in 8 weeks after treatment. Results In 8 weeks after the treatment, the 24-hour SBP/DBP was reduced by 14.92/9.96mmHg and 15.04/10.66mmHg respectively for groups I andⅡ, while the daytime SBP/DBP was decreased by 13.90/10.60mmHg and 16.06/ll.70mmHg, respectively. These indices were all significantly lower than before treatment （P 〈 0.01）, but there was no difference between the 2 groups （P 〉 0.05）. The nighttime SBP/DBP was reduced by 25.44/19.48mmHg in group I and by 17.68/14.76mmHg in group Ⅱ, and both were significantly lower than before treatment （P 〈 0.01, P〈 0.05）. The reversion of non-dipper hypertension was 88.16% and 55.41% for the 2 groups, with significant difference between them （P 〈 0.01）. Conclusion No matter small doses of levamlodipine, telmisartan and hydrochlorothiazide are given at the same or different time points, they effectively control the 24-hour and daytime blood pressures. But the drugs given at different time points can reverse non-dipper hypertension better.

关 键 词：左氨氯地平 替米沙坦 氢氯噻嗪 高血压 时间治疗学 

分 类 号：R341.3[医药卫生—基础医学]