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氢氯噻嗪联合盐酸贝那普利对非杓型高血压患者血压水平的影响(1)
http://www.100md.com 2011年7月1日 牟秀霞 胡元会 石洁
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     摘要:目的 按照时间治疗学原则,探讨不同时间服用氢氯噻嗪和盐酸贝那普利对新发1级、2级非杓型高血压患者血压水平的影响。方法 对62例非杓型高血压患者随机分为早氢氯噻嗪+早盐酸贝那普利组(早早组)和早氢氯噻嗪+晚盐酸贝那普利组(早晚组),共治疗8周。服药前后进行诊室血压测量和动态血压监测,观察药物对血压水平及血压昼夜节律的影响。结果 治疗后两组诊室收缩压(SBP)和舒张压(DBP)均较治疗前明显下降(P<0.05);两组间诊室SBP和DBP在治疗前后差异无统计学意义。动态血压结果显示,两组患者的24 hSBP和24 hDBP水平均较治疗前有明显下降(P<0.01)。早晚组患者的夜间SBP和DBP达标率明显高于早早组(P<0.01)。在血压昼夜节律纠正方面,早早组将非杓型纠正为杓型血压的比例为20%,早晚组将非杓型纠正为杓型的比例为40%(P<0.01)。结论 对于新发1级和2级非杓型高血压患者,联合服用氢氯噻嗪和盐酸贝那普利可以有效控制血压。晚上服用盐酸贝那普利可以较好地纠正夜间的高负荷血压,维持正常的昼夜变化节律。

    关键词:氢氯噻嗪;盐酸贝那普利;非杓型高血压;时间治疗学

    中图分类号:R544.1 R255.3 文献标识码:B 文章编号:1672-1349(2011)07-0783-03

    The Pharmacological Effects of Combination Therapy of Hydrochlorothiazide and Benazepril

    On Abnormal Blood Pressure Circadian Rhythm in Newly-onset Hypertension

    Mou Xiuxia,Hu Yuanhui,Shi Jie

    Department of Cardiovascuology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences(Beijing 100053)

    Abstract:Objective To investigate the pharmcochronological effect of combination therapy of hydrochlorothiazide and benazepril on blood pressure(BP)and circadian rhythm in patients with newly-onset,grade A and B hypertension.Methods Sixty two patients with non-dipper pattern of night BP were treated with combination of hydrochlorothiazide(morning dose) and benazepril (morning dose or evening dose)for 8 weeks.Results Both programs decreased office systolic blood pressure(SBP) and diastolic blood pressure(DBP)with no differences between them.The ambulatory blood pressure monitoring (ABPM) showed that both programs decreased 24 h SBP and 24 h DBP pronouncedly.The target nighttime SBP (<125 mmHg)and DBP(<75 mmHg) was achieved by evening program which was greatly higher than that by morning program.Circadian rhythm transformed from non-dipper to dipper was found in 20% in morning program versus 40% in the evening program( P<0.01).Conclusion The combination therapy of hydrochlorothiazide and benazepril was effective in decreasing blood pressure in patients with newly-onset ......

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