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目的观察不同给药时间对非勺型高血压病患者血压昼夜节律的影响及其对靶器官的保护作用。方法选择124例经24h动态血压监测(ABPM)血压状态属非勺型的轻至中度原发性高血压患者,随机分为清晨服药和午后服药两组。两组均选用复方利血平氨苯喋啶片(北京降压0号),一次一片,每日一次,用药8周,观察用药前后24h动态血压参数,比较两组血压昼夜节律的变化。结果清晨服药组治疗前后夜间平均收缩后(SBP),分别为(147.9±5.7)mmHg,(127.9±3.4)mmHg(P<0.001);午后服药组治疗前后夜间平均SBP分别为(148.8±8.1)mmHg,(126.8±5.9)mmHg(P<0.001)。清晨服药组治疗前后夜间平均舒张压(DBP)分别为(94.7±4.0)mmHg,(79.6±3.4)mmHg(P<0.001);午后服药组治疗前后夜间平均DBP分别为(95.5±4.8)mmHg,(74.5±4.1)mmHg(P<0.001)。两组SBP昼夜节律改变的有效率分别为62.90%,85.48%(P<0.01);DBP昼夜节律改变的有效率分别为64.52%,87.10%(P<0.01)。结论午后服药组不仅能24h平稳降低血压,而且能显著改变血压昼夜节律,从而达到保护靶器官的目的。
Objective To observe the effects of different administration time on blood pressure circadian rhythm and its protective effect on target organs in patients with non-spoon-type hypertension. Methods One hundred and twenty-four patients with mild to moderate essential hypertension whose blood pressure status was monitored by 24h ambulatory blood pressure monitoring (ABPM) were divided into two groups: early morning medication and late afternoon medication. The two groups were selected compound reserpine Triamterene tablet (Beijing blood pressure 0), once a day, medication for 8 weeks, observed 24h before and after treatment of ambulatory blood pressure parameters, blood pressure circadian rhythm changes were compared. Results The average nighttime SBP of the early morning medication group were (147.9 ± 5.7) mmHg and (127.9 ± 3.4) mmHg respectively (P <0.001) before and after treatment in the morning. The nighttime SBP of the afternoon medication group was (148.8 ± 8.1) mmHg, (126.8 ± 5.9) mmHg (P <0.001). The nighttime mean DBP was (94.7 ± 4.0) mmHg and (79.6 ± 3.4) mmHg before and after treatment in early morning (P <0.001), and the nighttime average DBP in morning afternoon was (95.5 ± 4.8) mmHg, (74.5 ± 4.1) mmHg (P <0.001). The effective rates of circadian rhythm change of SBP were 62.90% and 85.48% respectively (P <0.01). The effective rates of circadian rhythm of DBP were 64.52% and 87.10% respectively (P <0.01). Conclusion The afternoon medication group not only can reduce blood pressure smoothly 24h, but also can significantly change the circadian rhythm of blood pressure so as to achieve the goal of protecting the target organ.