依贝沙坦对血压昼夜节律变异的影响及护理对策

Effect of irbesartan on blood circadian variation reversion and nursing strategy

目的应用依贝沙坦治疗高血压病患者,观察其对血压昼夜节律变异的影响。方法107例初诊的未经治疗的原发性高血压病患者,给予口服依贝沙坦将血压控制在正常范围内。根据治疗前血压昼夜节律和治疗后血压昼夜节律逆转情况分为杓型组（29例）、逆转组（34例）和未逆转组（44例）。每位患者治疗前后均行24 h动态血压监测。结果3组患者在一般情况方面无显著性差异。治疗前逆转组和未逆转组的nSBp、nDBp均显著高于杓型组（P〈0.05）,治疗后逆转组和未逆转组患者dSBp、dDBp、nSBp、nDBp、24 h DBp和24 h SBp均较治疗前显著降低（P〈0.05）;但未逆转组nSBp和nDBp下降幅度明显低于逆转组（P〈0.05）,并且血压昼夜节律仍呈非杓型。结论依贝沙坦可将血压昼夜节律由非杓型部分逆转为杓型,降压效果明显。护士应加强健康教育,指导患者合理、规范用药,有效控制血压,减少并发症的发生。

Objective To assess the effect of irbesartan on blood circadian variation reversion of the patients with hypertension.Methods 107 patients who suffered primary hypertension and never received treatment were treated with irbesarta and then their blood pressure（Bp） was controlled in normal systolic range.According to the patients＇ circadian type before treatment and circadian variation reversion situation after treatment,they were divided into three groups： dipper group（n=29）,reversion group（n=34） and no-reversion group（n=44）.All patients underwent 24-hour ambulatory Bp monitoring.Results There was no significant difference in general data among three groups.Before the treatment,nocturnal systolic Bp（nSBp） and nocturnal diastolic Bp（nDBp） of the patients in reversion group and no-reversion group were higher than that of the patients in dipper group（P〈0.05）.After the treatment,dSBp,dDBp,nSBp,nDBp,24 hDBp,and 24 hSBp of the patients in reversion group and no-reversion group decreased significantly than before（P〈0.05）, especially in reversion group（P〈0.05）,and blood circadian variation reversions were still no-reversion type.Conclusions Irbesartan has the significant effect in hypertension,and changes the patient＇s Bp circadian variation from no-reversion type to reversion type partly.The nurses should emphasis on health education,guide medicine treatment,control Bp effectively and postpone the development of complications.