替米沙坦不同服药时间对非杓型伴清晨高血压患者疗效的对比研究  

Effect of telmisartan taken at different times on non-dipper and morning hypertension

作　　者：张莉[1] 庄梅[2] Zhang Li;Zhuang Mei(Department of Cardiology, NO. 1 People＇s Hospital, Neijiang 641000, Sichuan Province, China)

机构地区：[1]内江市第一人民医院心内科,641000 [2]贵州医科大学第一附属医院心内科

出　　处：《中华老年心脑血管病杂志》2018年第4期385-388,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨替米沙坦不同服药时间对非杓型伴清晨高血压患者24h动态血压监测各参数及血管内皮功能的影响。方法选择2014年9月~2015年12月贵州医科大学附属医院心内科就诊的原发性轻中度高血压患者80例,随机分为清晨服药组40例(07:00~09:00口服替米沙坦80 mg,1次/d)和夜晚服药组40例(19:00~21:00口服替米沙坦80mg,1次/晚),疗程12周。比较2组治疗后动态血压监测参数、血压模式、血管性血友病因子(von Willebrand factor,vWF)及高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平的变化。结果与清晨服药组比较,夜晚服药组治疗后夜间平均收缩压、夜间平均舒张压、清晨平均收缩压、清晨平均舒张压水平明显降低,差异有统计学意义(P<0.05)。与清晨服药组比较,夜晚服药组治疗后vWF和hs-CRP水平明显降低[(148.3±11.4)%vs(162.4±12.1)%,(2.9±0.5)mg/L vs(3.6±0.6)mg/L,P<0.05]。结论夜晚服用替米沙可降低非杓型伴清晨高血压患者的夜间及清晨血压水平、优化血压模式,并降低vWF、hs-CRP水平,而改善血管内皮功能。Objective To study the effect of telmisartan taken at different times on 24 hambulatory blood pressure monitoring（ABPM）parameters and vascular endothelium functionin in patients with non-dipper and morning hypertension.Methods Eighty mild-moderate essential hypertension（EH）patients admitted to the Affiliated Hospital of Guizhou Medical University from September 2014 to December 2015 were randomly divided into morning drug taking group（n=40）and evening drug taking group（n=40）.The patients in morning drug taking group took 80 mg telmisartan at h 7-9 in the morning and those in evening drug taking group took 80 mg telmisartan at h 19-21 in the evening for 12 weeks.Their ABPM parameters were recorded,their blood pressure and serum levels of von Willebrand factor（vWF）and hs-CRP were measured after treatment.Results The mean night and morning SBP and DBP were significantly lower in evening drug taking group than in morning drug taking group（P〈0.05）.The serum levels of vWF and hs-CRP were significantly lower in evening drug taking group than in morning drug taking group（148.3%±11.4%vs 162.4%±12.1%,2.9±0.5 mg/L vs 3.6±0.6 mg/L,P〈0.05）.Conclusion Telmisartan taken in the evening can reduce the night and morning blood pressure,serum vWF and hs-CRP levels,and improve the vascular endothelium function in patients with non-dipper and morning hypertension.

关 键 词：高血压 内皮 血管 血压监测 便携式 昼夜节律 von WILLEBRAND因子 C反应蛋白质 抗高血压药 

分 类 号：R544.1[医药卫生—心血管疾病]