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目的探讨早晨或夜间服用长效钙拮抗剂氨氯地平对老年非杓型高血压患者夜间血压的影响。方法选取122例2级非杓型原发性高血压患者,随机分为早晨服药组(A组)和晚间服药组(B组)治疗2周,治疗前后分别进行诊室血压和动态血压监测的检查。结果 (1)两组患者的诊室收缩压(SBP)和舒张压(DBP)均明显降低(P<0.05),两组之间诊室血压下降差值的比较差异无统计学意义(P>0.05)。(2)动态血压监测结果显示早晨服药和晚间服药均能降低24 h平均收缩压(24 hSBP)2、4 h平均舒张压(24 hDBP)、白昼平均收缩压(dSBP)、白昼舒张压(dDBP)、夜间平均收缩压(nSBP)和夜间舒张压(nDBP),差异有统计学意义(P<0.05)。(3)晚间服药组患者24 h平均收缩压(24 hSBP)和夜间平均收缩压(nSBP)明显低于早晨服药组患者(P<0.05)。结论早晨或晚间服用长效钙拮抗剂均能有效降低老年非杓型高血压患者的血压值,晚间服药组患者能更有效的降低夜间血压。
Objective To investigate the effect of long-acting calcium antagonist amlodipine on nocturnal blood pressure in elderly non-dipper hypertensive patients. Methods A total of 122 patients with grade 2 non-dipper essential hypertension were randomly divided into morning treatment group (group A) and evening treatment group (group B) for 2 weeks. Before and after treatment, blood pressure and ambulatory blood pressure monitoring were performed . Results (1) The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly decreased in both groups (P <0.05). There was no significant difference between the two groups in the difference of blood pressure drop between the two groups (P> 0.05) . (2) The results of ambulatory blood pressure monitoring showed that morning 24 h SBP, 24 h DBP, dSBP, dDBP ), Nighttime mean systolic blood pressure (nSBP) and nighttime diastolic blood pressure (nDBP), the difference was statistically significant (P <0.05). (3) The 24 h average systolic blood pressure (24 hSBP) and nighttime average systolic blood pressure (nSBP) in patients in the evening medication group were significantly lower than those in the morning medication group (P <0.05). Conclusion Long-acting calcium antagonists in the morning or evening can effectively reduce blood pressure in elderly non-dipper hypertensive patients, and patients in the evening medication group can reduce nocturnal blood pressure more effectively.