不同用药时间对原发性高血压患者晨峰血压的影响  

Influence of different medication time on morning blood pressure surge in patients with essential hypertension

作　　者：何善娴[1] 王以新[2] 王雷[1] 徐胜媛[1] 张淼淼[3] He Shanxian;Wang Yixin;Wang Lei;Xu Shengyuan;Zhang Miaomiao(The Second Outpatient Department,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of General Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of General Medicine,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京安贞医院第二门诊部,100029 [2]首都医科大学附属北京安贞医院全科医疗科,100029 [3]首都医科大学全科医学系,北京100069

出　　处：《中国医药》2018年第9期1288-1292,共5页China Medicine

基　　金：首都全科医学研究专项课题(15QK18)~~

摘　　要：目的探讨不同用药时间对原发性高血压患者晨峰血压的影响。方法选取2016年6月至2017年5月在首都医科大学附属北京安贞医院第二门诊部就诊的原发性高血压患者100例纳入观察组,选取同期在首都医科大学附属北京安贞医院心内科就诊的原发性高血压患者100例纳入对照组。对照组常规晨起(06:00—07:00)顿服替米沙坦片治疗;观察组患者口服替米沙坦片时间为20:00-21:00;2组替米沙坦剂量均为80 mg/次,1次/d。比较2组治疗前和治疗12个月后的诊室血压、24 h平均血压及晨峰血压增高情况。结果 2组治疗12个月后诊室收缩压、诊室舒张压、24 h平均收缩压、24 h平均舒张压均明显低于治疗前[对照组:(143±10)mmHg(1 mmHg=0.133 kPa)比(154±11)mmHg、(84±9)mmHg比(99±5)mmHg、(133±10)mmHg比(147±11)mmHg、(77±11)mmHg比(88±7)mmHg;观察组:(134±10)mmHg比(156±10)mmHg、(81±9)mmHg比(96±9)mmHg、(129±11)mmHg比(145±10)mmHg、(76±10)mmHg比(90±8)mmHg],差异均有统计学意义(均P<0.05)。2组治疗12个月后晨峰血压增高比例均明显低于治疗前[对照组:32.0%(32/100)比54.0%(54/100);观察组:14.0%(14/100)比47.0%(47/100)],观察组治疗前后晨峰血压增高情况减少比例高于对照组[70.2%(33/47)比40.7%(22/54)],差异均有统计学意义(均P<0.05)。结论原发性高血压患者晚间服药不仅能降低诊室血压和24 h平均血压,而且能明显减少晨峰血压的发生。Objective To investigate the influence of different medication time on morning blood pressure surge（MBPS） in patients with essential hypertension.Methods From June 2016 to May 2017,100 patients with essential hypertension at the Second Outpatient Department,Beijing Anzhen Hospital,Capital Medical University were enrolled as observation group;100 essential hypertension patients at Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University were enrolled as control group.The control group took telmisartan tablets 800 mg at 06：00-07：00 in the morning.The observation group took telmisartan tablets 800 mg at 20：00-21：00.Clinic blood pressure,24 h mean blood pressure and MBPS were analyzed before and 12 months after treatment.Results After treatment,clinic systolic and diastolic pressure,24 h mean systolic and diastolic pressure were significantly lower than those before treatment in both groups [control group：（143 ± 10） mmHg vs （154 ±＋ 11） mmHg,（84 ＋9） mmHg vs （99 ±＋ 5） mmHg,（133 ± 10） mmHg vs （147 ± 11） mmHg,（77 ± 11）mmHg vs （88 ± 7） mmHg;observation group：（134 ± 10） mmHg vs （156 ± 10） mmHg,（81 ± 9） mmHg vs （96 ± 9） mmHg,（129 ± 11） mmHg vs （145 ± 10） mmHg,（76 ± 10） mmHg vs （90 ± 8） mmHg] （all P 〈 0.05）.After treatment,the increase ratio of MBPS was significantly lower than that before treatment [control group：32.0% （32/100） vs 54.0% （54/100）;observation group：14.0% （14/100） vs 47.0% （47/100）];the decrease ratio of MBPS in the observation group was significantly higher than that in the control group [70.2% （33/47） vs 40.7% （22/54）] （all P 〈 0.05）.Conclusion Taking hypotensor at evening（20：00-21：00） can reduce clinic blood pressure,24 h average blood pressure and MBPS.

关 键 词：原发性高血压 时间治疗学 24H动态血压监测 晨峰血压 

分 类 号：R544.1[医药卫生—心血管疾病]