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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