左旋氨氯地平夜间给药对非杓型高血压患者动态动脉硬化指数及尿微量白蛋白的影响  

Influence of night administration of levamlodipine on ambulatory arterial stiffness index and microalbuminuria in patients with non-dipper hypertension

作　　者：娄满[1] 王宏业 高春燕[1] 苏宁[1] 胡晓英[1] 英俊岐[1] Lou Man;Wang Hongye;Gao Chunyan;Su Ning;Hu Xiaoying;Ying Junqi(First Department of Geriatrics,Harrison International Peace Hospital,Hengshui 053000,China;不详)

机构地区：[1]哈励逊国际和平医院老年病一科,衡水053000 [2]哈励逊国际和平医院中医科,衡水053000

出　　处：《中国循证心血管医学杂志》2021年第6期705-708,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省衡水市科技计划自筹经费项目(2016014091Z);河北省中医药科技计划项目(2019356)。

摘　　要：目的探讨左旋氨氯地平夜间给药对非杓型高血压患者动态动脉硬化指数(AASI)及尿微量白蛋白(MAU)的影响。方法选取2018年7月~2019年12月于哈励逊国际和平医院收治的非杓型高血压患者200例,按数表法随机分为对照组(n=100,晨时给药)和研究组(n=100,夜间给药)。比较两组患者的24 h动态血压参数、AASI、MAU、血压晨峰现象检出率、晨峰血压、非杓型血压检出率、夜间收缩压下降率及不良反应。结果治疗后两组患者的24 h平均收缩压(24 hSBP)、24 h平均舒张压(24 hDBP)均低于治疗前(P<0.05);治疗后两组夜晚平均SBP(nSBP)、夜间平均DBP(nDBP)均较治疗前低,且研究组低于对照组,而两组日间平均SBP(dSBP)、日间平均DBP(dDBP)较治疗前高,且研究组高于对照组(P<0.05);治疗后研究组AASI、MAU较对照组低(P<0.05);研究组治疗后血压晨峰现象检出率、晨峰血压、非杓型血压检出率均低于对照组,而夜间收缩压下降率较对照组高(P<0.05);对比两组不良反应发生率无统计学差异(P>0.05)。结论左旋氨氯地平夜间给药可改善非杓型高血压患者AASI及MAU,并可调节24 h血压、血压昼夜节律紊乱,抑制血压晨峰现象,安全性较高。Objective To discuss the influence of night administration of levamlodipine on ambulatory arterial stiffness index(AASI)and microalbuminuria(MAU)in patients with non-dipper hypertension.Methods The patients(n=200)were chosen from Harrison International Peace Hospital from July 2018 to Dec.2019,and divided randomly into control group(medicated in the morning)and test group(medicated at night,each n=100).The parameters of 24-h ambulatory blood pressure(BP),AASI,MAU,detection rate of BP morning peak phenomenon,morning BP surge(MBPS),detection rate of non-dipper BP,decrease rate of night systolic BP and adverse reactions were compared between 2 groups.Results The levels of 24-h mean systolic pressure(24-h MSP)and 24-h mean diastolic pressure(24-h MDP)were lower in 2 groups after treatment than before(P<0.05).The levels of night MSP and night MDP were lower in 2 groups after treatment than before,and were lower in test group than those in control group,and the levels of daily MSP and daily MDP were higher in 2 groups after treatment than before,and were higher in test group than those in control group(P<0.05).AASI and MAU were lower in test group than those in control group(P<0.05).The detection rate of morning peak phenomenon,MBPS and detection rate of non-dipper BP were lower,and decrease rate of night systolic BP was higher in test group than those in control group(P<0.05).The incidence rate of adverse reactions had no statistical difference between 2 groups(P>0.05).Conclusion The night administration of levamlodipine can improve AASI and MAU,regulate 24-h BP and disorders of BP circadian rhythm,and inhibit BP morning peak phenomenon with higher safety.

关 键 词：左旋氨氯地平 非杓型高血压 夜间 尿微量白蛋白 动态动脉硬化指数 

分 类 号：R544.1[医药卫生—心血管疾病]