本文關(guān)鍵詞： 樂(lè)卡地平 血壓變異性 24小時(shí)動(dòng)態(tài)血壓 家庭自測(cè)血壓　出處：《南京醫(yī)科大學(xué)》2017年博士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:比較鹽酸樂(lè)卡地平片與非洛地平緩釋片對(duì)輕中度原發(fā)性高血壓患者小時(shí)間血壓變異性以及逐日間血壓變異性的影響。方法:此研究是對(duì)鹽酸樂(lè)卡地平片治療輕中度原發(fā)性高血壓有效性的多中心、隨機(jī)、開(kāi)放、以非洛地平緩釋片為平行對(duì)照的臨床研究(NCT編號(hào):NCT01520285)的再分析。輕-中度原發(fā)性高血壓患者隨機(jī)進(jìn)入樂(lè)卡地平組或非洛地平組,接受樂(lè)卡地平10mg/d或非洛地平5mg/d治療,用藥共6周�；颊咴陔S機(jī)化前1周開(kāi)始每日測(cè)量家庭自測(cè)血壓并記錄,要求每天早晨和晚上連續(xù)3次測(cè)量并記錄。在基線(xiàn)和第6周時(shí)分別測(cè)量24小時(shí)動(dòng)態(tài)血壓。小時(shí)間血壓變異性定義為24小時(shí)動(dòng)態(tài)血壓每小時(shí)平均值的標(biāo)準(zhǔn)差。逐日間血壓變異性定義為每次訪(fǎng)視前1周內(nèi)家庭自測(cè)血壓每日血壓平均值(6個(gè)讀數(shù))的標(biāo)準(zhǔn)差。結(jié)果:此研究共納入186名患者(樂(lè)卡地平組89例,非洛地平組97例)。治療6周后,與基線(xiàn)相比,ABPM測(cè)得的樂(lè)卡地平組與非洛地平組的小時(shí)間舒張壓變異性均顯著降低(P0.05)。6周后,樂(lè)卡地平組的舒張壓變異性顯著低于非洛地平組(P0.05),但是兩組校正基線(xiàn)后的舒張壓變異性下降值并沒(méi)有顯著性差異(P=0.178)。兩組的收縮壓及舒張壓wSD在治療后均較基線(xiàn)顯著降低,且兩組之間沒(méi)有顯著性差異。治療6周后,HBPM測(cè)得的樂(lè)卡地平組與非洛地平組的逐日間收縮壓SD,逐日間舒張壓SD均顯著下降,兩組之間沒(méi)有顯著性差異,兩組校正基線(xiàn)后,逐日間收縮壓及舒張壓SD的下降值沒(méi)有顯著性差異。在基線(xiàn)和治療過(guò)程中,采用診室血壓、家庭自測(cè)血壓及24小時(shí)動(dòng)態(tài)血壓測(cè)得的收縮壓、舒張壓、心率均顯著相關(guān)。并且在基線(xiàn)時(shí),診室血壓值最高,其次為家庭自測(cè)血壓,再次為24小時(shí)動(dòng)態(tài)血壓。結(jié)論:鹽酸樂(lè)卡地平片與非洛地平緩釋片均能顯著降低輕中度原發(fā)性高血壓患者的小時(shí)間血壓變異性以及逐日間血壓變異性,且兩者降低血壓變異性的作用沒(méi)有顯著性差異。樂(lè)卡地平片是能有效改善血壓變異性的降壓藥物。
[Abstract]:Objective: to compare the effects of lokadipine hydrochloride and felodipine sustained-release tablets on small time blood pressure variability and daytime blood pressure variability in patients with mild and moderate essential hypertension. Multicenter efficacy in the treatment of mild to moderate essential hypertension, A randomized, open, parallel controlled clinical study with felodipine sustained-release tablets: a reanalysis of NCT No.: NCT01520285. patients with mild to moderate essential hypertension were randomly assigned to either the Lecardipine group or the felodipine group for 10 mg / d or 5 mg / d of felodipine. The patients began to measure and record their blood pressure daily one week before randomization. 24 hours ambulatory blood pressure is measured at baseline and 6 weeks, respectively. Small-time blood pressure variability is defined as the standard deviation of 24 hour mean ambulatory blood pressure per hour. Inter-blood pressure variability was defined as the standard deviation of the average daily blood pressure (6 readings) of family blood pressure measured within one week before each visit. Results: the study included 186 patients (89 patients in the Lecardipine group). After 6 weeks of treatment, the small time diastolic blood pressure variability of Lecardipine group and felodipine group was significantly lower than that of baseline group after 6 weeks of treatment. Diastolic blood pressure variability in Lecardipine group was significantly lower than that in felodipine group (P 0.05), but there was no significant difference in diastolic blood pressure variability between the two groups after correction of baseline. Systolic blood pressure and diastolic blood pressure (wSD) in both groups were significantly lower than baseline after treatment. There was no significant difference between the two groups. After 6 weeks of treatment, the daily systolic blood pressure (SDD) and daytime diastolic blood pressure (SD) of Lecardipine group and felodipine group were significantly decreased, and there was no significant difference between the two groups. There was no significant difference between day to day systolic blood pressure (SBP) and diastolic blood pressure (DBP). During baseline and treatment, systolic and diastolic blood pressure were measured by using diagnostic room blood pressure, home blood pressure and 24 hour ambulatory blood pressure. Heart rate was significantly correlated. At baseline, the blood pressure in the clinic was the highest, followed by self-measured blood pressure in the family. Conclusion: both lokadipine hydrochloride and felodipine sustained-release tablets can significantly reduce the small time blood pressure variability and daily blood pressure variability in patients with mild to moderate essential hypertension. There was no significant difference between the two groups in reducing blood pressure variability. Lecardipine is an effective antihypertensive drug for improving blood pressure variability.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R544.11

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本文編號(hào)：1499390