不同服药时间对老年非杓型高血压患者血压的影响  

Effect of different time of taking medicine on blood pressure of elderly patients with non-dipper hypertension

作　　者：赵丽庆[1] 刘士俊[1] 甘标[1] 

机构地区：[1]广东省广州市海珠区疾病预防控制中心,510288

出　　处：《职业与健康》2015年第13期1794-1797,1801,共5页Occupation and Health

基　　金：2012年度广州市海珠区医疗卫生指导性科技计划项目(项目编号:2012-y1-09)

摘　　要：目的探讨不同时间服用硝苯地平控释片对原发性轻中度老年非杓型高血压患者血压的影响。方法采用配对设计方法,将244例老年非杓型高血压患者随机分为夜间服药组(A组)和清晨服药组(B组),分别在19:00-21:00和7:00-9:00给予口服硝苯地平控释片(30 mg/d),连续治疗48周。于治疗前后,对两组患者进行24 h动态血压监测,测量左室舒张末期内径(LVEDD)和室间隔厚度(IVST)。结果治疗后,A组各项动态血压指标值(24h SBP、n SBP、d SBP、24h DBP、n DBP、d DBP)均显著低于B组(P<0.01);A组的动态血压达标率(91.80%)显著高于B组(77.87%)(χ2=9.207,P<O.01);A组有101例血压昼夜节律由非杓型转变为杓型,显著多于B组的60例(χ2=30.694,P<0.01);A组的晨峰血压(MBPS)、LVEDD和IVST均显著低于B组(P<0.01);两组不良反应无差别。结论夜间服用硝苯地平控释片对防治老年非杓型高血压的疗效明显优于清晨服药的疗效。[Objeetive] To investigate the effects of taking Nifedipine Controlled-release Tablets in different time on blood pressure of elderly patients with non-dipper mild and moderate hypertension. [ Methods ] By using the paired design, 244 elderly patients with non-dipper hypertension were randomly divided into night medication group （group A） and early morning medication group （group B）. Patients in group A took Nifedipine Controlled-release Tablets （30mg） between 19：00-21：00 every day, while patients in group B took the same medicine （30rag） between 7：00-9：00 in the morning every day. All of them were treated for 48 weeks. Before and after treatment, the patients of two groups received 24-hour ambulatory blood pressure monitoring, and LVEDD and IVST of patients were also detected. [Results] After treatment, all dynamic blood pressure values （24 h SBP, nSBP, dSBP, 24 h DBP, nDBP and dDBP） in group A were significantly lower than those in group B （P〈0.01）. The blood pressure control rate of group A （91.80%） was higher than that in group B （77.87%） significantly （χ2=9.207, P〈0.01）. The circadian rhythm of blood pressure was changed from non-dipper to dipper type in 101 patients of group A after treatment, which was 60 patients of group B （χ2=30.694, P〈0.O01）. Morning blood pressure surge （MBPS）, LVEDD and IVST in group A were significantly lower than those in group B （P〈0.01）, and there was no significant difference in rate of untoward reactions between two groups.[ Conclusion ] Taking Nifedipin Controlled-release Tablets in evening has better effect in treatment of non-dipper hypertension in elderly patients than taking medicine in the morning.

关 键 词：老年人 非杓型高血压 时间治疗学 治疗结果 

分 类 号：R181.32[医药卫生—流行病学]