摘要
目的:探讨替米沙坦不同给药时间对轻中度原发性高血压病患者动态血压监测参数及超敏C反应蛋白(hs-CRP)水平的影响。方法:选取2016年1月至2018年4月东莞三局医院收治的轻中度原发性高血压病患者120例,采用随机数字表法分为对照组、观察组,每组60例。两组患者均给予替米沙坦,其中对照组患者于清晨给药,观察组患者于夜间给药。治疗期间行常规随访,测定两组患者的动态血压水平[24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、清晨(6:00—10:00)的平均收缩压(mSBP)和舒张压(mDBP)、日间平均收缩压(dSBP)和舒张压(dDBP)及夜间平均收缩压(nSBP)和舒张压(nDBP)];测定两组患者hs-CRP、血管性血友病因子(vWF)水平,并观察两组患者血压类型和不良反应发生情况。结果:治疗后,两组患者24 h SBP、24 h DBP、mSBP、mDBP、dSBP、dDBP、nSBP及nDBP水平较治疗前明显降低,且观察组患者mSBP、mDBP、nSBP及nDBP水平明显低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者hs-CRP、vWF水平明显低于对照组,差异均有统计学意义(P<0.05);治疗后,对照组患者杓型血压率为23.33%(14/60),观察组患者杓型血压率为53.33%(32/60),两组的差异有统计学意义(P<0.05);治疗期间仅少数患者发生不良反应,症状轻微,且均能够在短期内自行缓解,未影响治疗。结论:轻中度原发性高血压病患者夜间服用替米沙坦的血压控制效果显著优于清晨服药,且可使血压节律恢复正常杓型,利于保护周围动脉,兼具较高安全性。
OBJECTIVE:To probe into the effects of different administration time of telmisartan on ambulatory blood pressure monitoring parameters and high-sensitivity C-reactive protein(hs-CRP)levels in patients with primary mild to moderate hypertension. METHODS:120 patients with hypertension admitted into Dongguan Sanju Hospital from Jan. 2016 to Apr. 2018 were selected and divided into control group and observation group via random number table, with 60 cases in each group. Both groups were given telmisartan, of which the control group was administrated at early morning, and the observation group was administrated at night. Conventional follow-up was conducted during treatment to measure the ambulatory blood pressure [mean systolic blood pressure in 24 h(24 h SBP), mean diastolic blood pressure in 24 h(24 h DBP), mean systolic blood pressure(mSBP) and mean diastolic blood pressure(mDBP) at early morning(6:00-10:00), mean systolic blood pressure at daylight(dSBP) and mean diastolic blood pressure at daylight(dDBP), mean systolic blood pressure at night(nSBP) and mean diastolic blood pressure at night(nDBP)];the hs-CRP and von Willebrand factor(vWF) levels were measured, the blood pressure types and incidences of adverse drug reactions of two groups were observed. RESULTS:After treatment, the 24 h SBP, 24 h DBP, mSBP, mDBP, dSBP, dDBP, nSBP and nDBP of both groups were significantly lower than those of before treatment, the mSBP, mDBP, nSBP and nDBP of observation group were significantly lower than those of the control group, with statistically significant differences(P<0.05);after treatment, the hs-CRP and vWF levels of observation group were significantly lower than those of the control group, with statistically significant differences(P<0.05);after treatment, the rate of dipper-type blood pressure of control was 23.33%(14/60), and that of the observation group was 53.33%(32/60), the inter-group comparison had statistically significant difference(P<0.05);only few patients developed adverse drug reactions during treatment, with mild symptoms and resolved spontaneously in a short period without affecting treatment. CONCLUSIONS:The effect of telmisartan on blood pressure control at night in patients with primary mild to moderate hypertension is significantly better than that at early morning, which can restore the blood pressure rhythm to normal dipper type and is beneficial to protect surrounding arteries, with high safety.
作者
卓练强
叶柳青
熊方
ZHUO Lianqiang;YE Liuqing;XIONG Fang(Dept.of Emergency Internal Medicine,Dongguan Sanju Hospital,Guangdong Dongguan 523710,China;Electrocardiogram Room,Dongguan Sanju Hospital,Guangdong Dongguan 523710,China)
出处
《中国医院用药评价与分析》
2019年第3期312-314,共3页
Evaluation and Analysis of Drug-use in Hospitals of China
