目的分析氨氯地平联合厄贝沙坦不同用药时间对原发性高血压患者晨峰现象及血压变异性的影响,为临床原发性高血压治疗方案的改进提供参考。方法以2014年1月至2016年1月河南省濮阳市油田总医院收治的200例原发性高血压患者为研究对象,根据入组先后顺序分为对照组66例,观察A组67例和观察B组67例,对照组每日晨起7:00-8:00顿服氨氯地平和厄贝沙坦,观察A组每日晨起7:00-8:00顿服氨氯地平,晚间19:00-20:00顿服厄贝沙坦,观察B组每日晨起7:00-8:00顿服厄贝沙坦,晚间19:00-20:00顿服氨氯地平,3组均连续治疗2个月。治疗前后3组患者均测量24 h动态血压,记录3组患者24 h、白天、夜间舒张压和收缩压(24 hDBP和24 hSBP、dDBP和dSBP、nDBP和nSBP),计算24 h、白天、夜间的舒张压和收缩压标准差(24 hDSD和24 hSSD、dDSD和dSSD、nDSD和n SSD),比较3组的血压变异性和血压晨峰阳性发生率。用SPSS 19.0统计学软件进行数据的统计处理。结果治疗前,3组患者各血压值(24 hSBP、24 hDBP、dSBP、dDBP、nSBP和n DBP)比较,差异均无统计学意义(P>0.05)。治疗后3组患者各血压值均较治疗前明显降低,且观察A组和观察B组患者24 hSBP、d SBP和n SBP均明显低于对照组,差异均有统计学意义(P<0.05),观察A组和观察B组之间各血压值比较,差异均无统计学意义(P>0.05);治疗后3组各血压变异值均较治疗前明显降低,且观察A组和观察B组24 hDSD、24 hSSD、d DSD、d SSD和n SSD均明显低于对照组,差异均有统计学意义(P<0.05);治疗后3组患者血压晨峰阳性发生率均较治疗前明显降低,且观察A组和观察B组血压晨峰阳性发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论早晚分服氨氯地平和厄贝沙坦联合治疗原发性高血压可有效控制患者血压,并可显著降低血压变异性和血压晨峰阳性发生率。 Objective To analyze the influence of amlodipine and irbesartan on the morning peak phenomenon and the variability of blood pressure in patients with essential hypertension, and to provide reference for the improvement of clinical treatment of essential hypertension. Methods From January 2014 to January 2016, 200 cases of patients with essential hypertension treated in Puyang Oilfield General Hospital of Henan Province were enrolled. According to the sequence of enrollment, 66 cases were divided into control group, 67 cases in group A and 67 patients in group B were treated with amlodipine daily for 7: 00-8: 00 amidst the morning of the morning in group A, and the control group was treated with amlodipine and irbesartan daily at 7: 00-8: 00 am. Evening 19: 00-20: 00 served irbesartan, observation group B daily morning 7: 00-8: 00 served irbesartan, 19:00 am-20: 00 pm amlodipine, 3 groups were treated for 2 months. Ambulatory blood pressure was measured at 24 hours before and after treatment. The diastolic blood pressure and systolic blood pressure (24 h DBP and 24 h SBP, dDBP and dSBP, nDBP and nSBP) in 24 hours, daytime and nighttime Diastolic blood pressure and systolic blood pressure standard deviation (24 hDSD and 24 hSSD, dDSD and dSSD, nDSD and n SSD) were compared. The blood pressure variability and the positive incidence of morning blood pressure were compared among the three groups. Using SPSS 19.0 statistical software for statistical processing of data. Results Before treatment, there were no significant differences in blood pressure (24 hSBP, 24 h DBP, dSBP, dDBP, nSBP and n DBP) between the three groups (P> 0.05). After treatment, the blood pressure of the three groups of patients were significantly lower than those before treatment, and the 24 hSBP, d SBP and n SBP in observation group A and B group were significantly lower than those in control group (P <0.05) (P> 0.05). After treatment, the blood pressure variability in 3 groups was significantly lower than that before treatment, and the changes of blood pressure in group A and group B were observed 24 h SDD, 24 h SDSD, d DSD, d SSD and n SSD were all significantly lower than those of the control group (P 0. 05). The positive rates of morning peak of blood pressure in the three groups after treatment were significantly lower than those before treatment , And the incidence of morning peak of blood pressure in observation group A and observation group B were significantly lower than that of the control group, the difference was statistically significant (P <0.05). Conclusion The combination of amlodipine and irbesartan in the morning and evening can effectively control the blood pressure in patients with essential hypertension and can significantly reduce the variability of blood pressure and the peak incidence of morning sickness.