不同服藥方法對原發(fā)性高血壓患者降壓療效的影響
發(fā)布時間：2019-04-23 23:28
【摘要】：目的:探討不同服藥方法對原發(fā)性高血壓患者降壓療效的影響。方法:選取規(guī)律口服兩種及以上長效降壓藥物、診室血壓140/90mm Hg的高血壓患者,完善24h動態(tài)血壓監(jiān)測(24h ABPM)后予調(diào)整服藥方法,由原來的晨起頓服改為分次服用,即晨起服用一種,下午4時至6時服用另一種,或者由原來的分次服調(diào)整為晨起頓服,隨訪觀察8周后復(fù)查24h動態(tài)血壓監(jiān)測(24h ABPM)比較各血壓參數(shù)。結(jié)果:入選并完成研究的原發(fā)性高血壓(EH)患者60例,平均年齡(64.7±9.4)歲,男性19例(31.7%)。分次服組與頓服組比較,分次服組,24h平均收縮壓(24h SBP)(128.15±9.51)mm Hg vs(130.91±10.37)mm Hg,下降了(2.76±10.30)mm Hg,t=2.077,P0.05;白天平均收縮壓(d SBP)(129.33±9.92)mm Hg vs(132.36±10.34)mm Hg,降低了(2.97±10.77)mm Hg,t=2.138,P0.05;夜間平均收縮壓(n SBP)(118.90±11.96)mm Hg vs(124.12±13.00)mm Hg,降低了(5.22±12.89)mm Hg,t=3.139,P0.05;夜間平均舒張壓(n DBP)(66.20±7.39)mm Hg vs(69.24±8.50)mm Hg,降低了(3.04±9.15)mm Hg,t=2.574,P0.05;夜間平均脈壓(n PP)[(52.70±10.51)mm Hg vs(55.00±10.57)mm Hg,降低了(2.30±6.46)mm Hg,t=2.758,P0.05。但是,分次服組與頓服組,24h平均舒張壓(24h DBP)、24h脈壓平均值(24h PP)、白天平均舒張壓(d DBP)、白天脈壓平均值(d PP)、24h收縮壓變異性(24h SSD)、24h舒張壓變異性(24h DSD)、24h脈壓變異性、白天收縮壓變異性(d SSD)、白天舒張壓變異性(d DSD)、白天脈壓變異性(d PSD)、夜間舒張壓變異性(n DSD)、清晨血壓平均值(MBP)、清晨血壓變異性(MBPSD)、血壓晨峰(MBPS),差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:聯(lián)合長效降壓藥物治療原發(fā)性高血壓患者,分次服與晨起頓服比較,分次服能有效地降低全天收縮壓水平、更有效的降低夜間血壓,晝夜血壓差值改善利于恢復(fù)杓型血壓節(jié)律。
[Abstract]:Objective: to investigate the effect of different medication methods on the antihypertensive effect in patients with essential hypertension (EH). Methods: the patients with hypertension who took two or more long-acting antihypertensive drugs regularly and the patients with 140/90mm Hg in the clinic were adjusted after 24-hour ambulatory blood pressure monitoring (24-hour ABPM). After 8 weeks of follow-up observation, 24-hour ambulatory blood pressure monitoring (24-hour ABPM) was performed to compare the parameters of blood pressure. The blood pressure parameters were compared by 24-hour ambulatory blood pressure monitoring (24-hour ambulatory blood pressure monitoring) after 8 weeks of follow-up observation. Results: 60 patients with essential hypertension (EH) were enrolled and completed. The mean age was (64.7 鹵9.4) years, and 19 cases (31.7%) were male. The mean systolic blood pressure (24 h SBP) (128.15 鹵9.51) mm Hg vs (130.91 鹵10.37) mm Hg,) decreased by (2.76 鹵10.30) mm Hg,t=2.077,P0.05; in the fractionated group compared with the control group. Daytime mean systolic blood pressure (d SBP) (129.33 鹵9.92) mm Hg vs (132.36 鹵10.34) mm Hg,) decreased by (2.97 鹵10.77) mm Hg,t=2.138,P0.05;. Nocturnal mean systolic blood pressure (n SBP) (118.90 鹵11.96) mm Hg vs (124.12 鹵13.00) mm Hg,) decreased by (5.22 鹵12.89) mm Hg,t=3.139,P0.05;. Nocturnal mean diastolic pressure (n DBP) () 66.20 鹵7.39) mm Hg vs (69.24 鹵8.50) mm Hg, decreased by (3.04 鹵9.15) mm Hg,t=2.574,P0.05; The mean nocturnal pulse pressure (n PP) [(52.70 鹵10.51) mm Hg vs () 55.00 鹵10.57) mm Hg,] decreased by (2.30 鹵6.46) mm Hg,t=2.758,P0.05.. However, 24 h mean diastolic blood pressure (24 h DBP), 24 h pulse pressure) (24 h PP), daytime mean diastolic blood pressure (d DBP), daytime mean (d PP), 24 h systolic blood pressure variability (24 h SSD),) was observed in the two groups: 24 h diastolic blood pressure (24 h DBP) and 24 h DBP (24 h SSD),). 24h diastolic pressure variability (24h DSD), 24h pulse pressure variability, daytime systolic blood pressure variability (d SSD), daytime diastolic pressure variability (d DSD), daytime pulse pressure variability (d PSD), nocturnal diastolic pressure variability (n DSD), Morning blood pressure mean (MBP), early morning blood pressure variability (MBPSD), blood pressure morning peak (MBPS), difference was not statistically significant (P0.05). Conclusion: the combination of long-term antihypertensive drugs in the treatment of essential hypertension patients, compared with morning-to-morning treatment, fractional administration can effectively reduce the level of systolic blood pressure throughout the day, more effective to reduce blood pressure at night. The improvement of dipper blood pressure difference is beneficial to the recovery of dipper blood pressure rhythm.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.11
本文編號：2463901
[Abstract]:Objective: to investigate the effect of different medication methods on the antihypertensive effect in patients with essential hypertension (EH). Methods: the patients with hypertension who took two or more long-acting antihypertensive drugs regularly and the patients with 140/90mm Hg in the clinic were adjusted after 24-hour ambulatory blood pressure monitoring (24-hour ABPM). After 8 weeks of follow-up observation, 24-hour ambulatory blood pressure monitoring (24-hour ABPM) was performed to compare the parameters of blood pressure. The blood pressure parameters were compared by 24-hour ambulatory blood pressure monitoring (24-hour ambulatory blood pressure monitoring) after 8 weeks of follow-up observation. Results: 60 patients with essential hypertension (EH) were enrolled and completed. The mean age was (64.7 鹵9.4) years, and 19 cases (31.7%) were male. The mean systolic blood pressure (24 h SBP) (128.15 鹵9.51) mm Hg vs (130.91 鹵10.37) mm Hg,) decreased by (2.76 鹵10.30) mm Hg,t=2.077,P0.05; in the fractionated group compared with the control group. Daytime mean systolic blood pressure (d SBP) (129.33 鹵9.92) mm Hg vs (132.36 鹵10.34) mm Hg,) decreased by (2.97 鹵10.77) mm Hg,t=2.138,P0.05;. Nocturnal mean systolic blood pressure (n SBP) (118.90 鹵11.96) mm Hg vs (124.12 鹵13.00) mm Hg,) decreased by (5.22 鹵12.89) mm Hg,t=3.139,P0.05;. Nocturnal mean diastolic pressure (n DBP) () 66.20 鹵7.39) mm Hg vs (69.24 鹵8.50) mm Hg, decreased by (3.04 鹵9.15) mm Hg,t=2.574,P0.05; The mean nocturnal pulse pressure (n PP) [(52.70 鹵10.51) mm Hg vs () 55.00 鹵10.57) mm Hg,] decreased by (2.30 鹵6.46) mm Hg,t=2.758,P0.05.. However, 24 h mean diastolic blood pressure (24 h DBP), 24 h pulse pressure) (24 h PP), daytime mean diastolic blood pressure (d DBP), daytime mean (d PP), 24 h systolic blood pressure variability (24 h SSD),) was observed in the two groups: 24 h diastolic blood pressure (24 h DBP) and 24 h DBP (24 h SSD),). 24h diastolic pressure variability (24h DSD), 24h pulse pressure variability, daytime systolic blood pressure variability (d SSD), daytime diastolic pressure variability (d DSD), daytime pulse pressure variability (d PSD), nocturnal diastolic pressure variability (n DSD), Morning blood pressure mean (MBP), early morning blood pressure variability (MBPSD), blood pressure morning peak (MBPS), difference was not statistically significant (P0.05). Conclusion: the combination of long-term antihypertensive drugs in the treatment of essential hypertension patients, compared with morning-to-morning treatment, fractional administration can effectively reduce the level of systolic blood pressure throughout the day, more effective to reduce blood pressure at night. The improvement of dipper blood pressure difference is beneficial to the recovery of dipper blood pressure rhythm.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R544.11
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