白天或夜间服用左旋氨氯地平治疗原发性收缩期高血压的临床效果比较

Comparison of clinical effects between day and night taking Levamlodipine treatment on essential systolic hypertension

目的探讨原发性收缩期高血压患者白天和夜间服用左旋氨氯地平降压疗效的差异。方法选取2008年5月～2012年11月浙江省安吉县人民医院收治的160例原发性收缩期高血压患者作为研究对象，随机分为白天服药组和夜间服药组，各80例，两组均服用左旋氨氯地平。白天服药组于7：00-9：00服药，夜间服药组于19：00-21：00服药。1年后比较两组血压水平和血压达标情况。结果①治疗后白天服药组和夜间服药组的诊室收缩压（SBP）分别为（133．5±7．1）mmHg和（133．7±7．3）mmHg，两组诊室SBP治疗后均下降（P〈0．05），组间治疗前后比较差异均无统计学意义（P〉0．05）。②夜间服药组治疗前后的24hSBP分别为（134．8±8．4）mmHg和（129．7±7．9）mmHg，治疗后较治疗前有所下降（P〈0．05）。白天服药组治疗前后的夜SBP分别为（131．7±7．8）mmHg和（125．2±7．1）mmHg，夜间服药组为（132．2±8．1）mmHg和（123．9±7．4）mmHg，治疗后两组夜SBP均有所下降（P〈0．05），但夜间服药组下降更加明显（P〈0．01）。③白天服药组和夜间服药组夜血压达标例数分别为22例（27．5％）和51例（63．8％），差异有高度统计学意义（P〈0．01）。结论不同时间服用左旋氨氯地平均能有效地降低诊室SBP，但夜间服药能更有效地纠正夜间高血压，提高夜间血压达标率。

Objective To investigate the difference of clinical effects between day and night taking Levamlodipine treatment on essential systolic hypertension. Methods From May 2008 to November 2012, 160 patients with primary systolic hypertension in Department of Cardiology in Anji County People＇s Hospital of Zhejiang Province as research subjects were randomly divided into daytime medication group and nighttime medication group, 80 cases in each group, all accepted Levamlodipine therapy. Daytime medication group did it during 7：00-9：00, nighttime medication group did it during 19：00-21：00. After 1 year, blood pressure levels and blood pressure were compared between the two groups. Results （~）After 1 year, the blood pressure （SBP） of the two groups were （133.5-±7.1） mm Hg and （133.7±7.3） mm Hg, which were all lower than before treatment （P 〈 0.05）, but there was no significant difference between the two groups （P 〉 0.05）. （~）In nighttime medication group, before and after treatment, the 24 h SBP were （134.8±8.4） mm Hg and （129.7±7.9） mm Hg, which decreased compared with before treatment （P 〈 0.05）. The night SBP of the daytime medication group were （131.7±7.8） mm Hg and （125.2±7.1） mm Hg before and after treatment, while in the nighttime medication group, they were （132.2±8.1） mm Hg and （123.9±7.4） mm Hg, which were all lower than before treatment （P 〈 0.05）, but the nighttime medication group decreased more significantly （P 〈 0.01）. ①Standard blood pressure number of daytime and nighttime medication groups were 22 cases （27.5%） and 51 cases （63.8%）, the difference was significant （P 〈 0.01）. Conclusion Different time taking Levamlodipine can effectively reduce the average clinic SBP, but nighttime medica- tion can more effectively correct nighttime hypertension, improve compliance rate of nighttime blood pressure.