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目的观察不同时间联合应用“氨氯地平+复方阿米洛利”对血压、晨峰现象、血压模式影响及对心、肾靶器官的保护作用。方法于2008-03-2009-06选取重庆大坪医院、重庆黔江中心医院、重庆双桥区医院的高血压患者80例,随机分为两组:早上服药组(n=40)和睡前服药组(n=40),分别于8:00和22:00服用氨氯地平5mg及复方阿米洛利半片,连续服药12周。于服药前及12周末进行动态血压检测,分析不同时间给药对血压、晨峰现象、血压模式的影响。结果早上服药、睡前服药两组患者降压总有效率均达97.5%。但与早上服药组相比,睡前服药组患者血压晨峰现象缓解,夜间血压下降率[服药后收缩压:(13.2±3.3)比(9.9±3.6)%;服药后舒张压:(13.9±3.8)比(10.5±3.2)%]明显增加,高血压患者异常的血压昼夜节律明显改善甚至恢复正常。结论不同时间服用“氨氯地平+复方阿米洛利”降血压效果存在差别,夜晚服药较清晨服药对缓解血压晨峰现象、改善异常的血压昼夜节律有明显的优势。
Objective To observe the effects of combined use of amlodipine and amiloride on blood pressure, morning peak, blood pressure pattern and target organs in heart and kidney in different time. Methods Eighty patients with hypertension in Chongqing Daping Hospital, Chongqing Qianjiang Central Hospital and Chongqing Shuangqiao District Hospital were randomly divided into two groups: morning medication group (n = 40) and bedtime medication group (n = 40). Amlodipine 5mg and amiloride half tablets were taken respectively at 8:00 and 22:00 for 12 weeks. Before taking medication and 12 weeks of ambulatory blood pressure testing, analysis of different time of administration of blood pressure, morning peak phenomenon, blood pressure mode. Results The morning medication, bedtime medication in both groups, the total effective rate was 97.5%. However, compared with the morning medication group, the peak morning blood pressure of patients in the medication group at bedtime was relieved and the nocturnal decline in blood pressure [systolic blood pressure after medication: (13.2 ± 3.3) vs (9.9 ± 3.6)%; diastolic blood pressure after medication: (13.9 ± 3.8) (10.5 ± 3.2)%] significantly increased abnormal blood pressure circadian rhythm in patients with hypertension significantly improved or even returned to normal. Conclusion Taking different doses of amlodipine and amiloride at different times has different effect on blood pressure lowering. Taking medicine at night in the early morning can relieve the morning peak of blood pressure and improve the circadian rhythm of abnormal blood pressure obviously.