时间药理学对冠状动脉介入术后患者夜间血压下降的影响  

Effect of chronopharmacology-based antihypertension on decreasing nocturnal hypertension in percutaneous coronary intervention patients

作　　者：孔羽[1] 李全[2] 杜鹃 潘晓冬[4] 马会娟 KONG Yu;LI Quan;DU Juan;PAN Xiaodong;MA Huijuan(Department of Hypertension,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管病研究所高血压科,100029 [2]首都医科大学附属北京安贞医院-北京市心肺血管病研究所心内科,100029 [3]首都医科大学附属北京安贞医院-北京市心肺血管病研究所检验科,100029 [4]北京市心肺血管疾病研究所 [5]首都医科大学附属北京安贞医院-北京市心肺血管病研究所高血压科动态血压监测室,100029

出　　处：《心肺血管病杂志》2019年第1期6-9,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨基于时间药理学降压对冠状动脉介入(PCI)术后患者夜间血压下降的影响。方法:入选2015年7月至2017年7月,首都医科大学附属北京安贞医院高血压科门诊中合并轻、中度高血压的PCI术后患者85例。采用简单数字随机法分为传统方法服药组和时间药理学服药组,分别是43例和42例。传统方法服药组[晨起6时服用β受体阻滞剂和血管紧张素转化酶抑制剂(ACEI)]和时间药理学服药组(晨起6时服用β受体阻滞剂和晚间5时服用ACEI)共治疗4周。在基线和治疗4周后进行24h动态血压监测并分析。结果:入选患者年龄43～78岁,4周规范降压治疗后血压控制达标率为80%,分别在在血压达标和未达标患者中进行比较,时间药理学服药组24h平均血压水平和夜间血压下降率方面均较传统方法服药组明显改善,差异有统计学意义(P<0. 05)。结论:PCI术后患者夜间血压升高,依据降压药物时间药理学原则给予治疗能更有效控制患者夜间血压,恢复正常心血管生理节律。Objective:To investigate the effect of chronopharmacology-based anti-hypertension on nocturnal blood pressure after percutaneous transluminal coronary intervention(PCI).Methods:From July 2015 to July 2017,85 outpatients of Hypertension department with mild to moderate hypertension who underwent PCI were enrolled.These patients were randomly divided into traditional medication group or chronopharmacology medication group,43 and 42 cases respectively.Traditional medication group tookβblocker and angiotensin converting enzyme inhibitors(ACEI)at 6 in the morning and the chronopharmacology medication group takeβblocker at 6 in the morning and ACEI at 5 in the evening.After 4 weeks antihypertensive medication,24-hour ambulatory blood pressure monitoring and analysis were performed at baseline and 4 weeks treatment.Results:The enrolled patients were 43-78 years old.After 4 weeks standard antihypertensive treatment,the proportion of patients reaching blood pressure target was 80%.Compared with the traditional medication group,the 24h mean blood pressure parameters and nocturnal blood pressure fall rate in the chronopharmacology medication group were much better and the difference was statistically significant(P<0.05).Conclusions:The blood pressure of patients with PCI is elevated at night,and the chronopharmacology-based antihypertension can be more effective at lowering the non-dipper nocturnal hypertension and restore the normal circadian rhythm of cardiovascular system.

关 键 词：经皮穿冠状动脉介入术 时间药理学 夜间血压下降率 

分 类 号：R54[医药卫生—心血管疾病]