马来酸左旋氨氯地平对高血压患者血压昼夜节律和清晨血压的影响

Effect of L-amlodipine maleate on circadian rhythms and morning hypertension in hypertensive patients

目的：应用24 h动态血压监测（ambulatory blood pressure monitoring,ABPM）评价马来酸左旋氨氯地平治疗对高血压患者血压昼夜节律和清晨血压的影响。方法：入选109例原发性高血压患者,口服马来酸左旋氨氯地平2.5~5 mg·d-1,基线和治疗8周时进行24 h ABPM检查,比较治疗前后患者夜间和清晨血压的变化情况。结果：87例患者完成研究。治疗后患者24 h平均血压、日间平均血压、夜间平均血压和清晨平均血压等均有明显降低（P〈0.05）;清晨高血压患者比例由治疗前的68.97%降至治疗后36.78%（P〈0.05）,但治疗前后血压昼夜节律分布未见明显改善;收缩压和舒张压的谷峰比值均〉50%,平滑指数均〉1。随访中患者均无严重不良反应发生。结论：马来酸左旋氨氯地平具备平稳长效的降压效果,能有效调节患者夜间和清晨血压水平,是控制清晨血压可选的长效药物。

Objective： To evaluate the antihypertensive effect of L-amlodipine maleate in patients with essential hypertension using 24-h ambulatory blood pressure monitoring（ ABPM）. Methods： A total of 109 patients with essential hypertension from January to July 2009 were enrolled in this study. Patients were treated with L-amlodipine maleate 2. 5 ~ 5 mg·d- 1and 24 h ABPM was performed in patients before and 8 weeks after treatment,respectively. Results： The mean blood pressure in the 24 h,diurnal,nocturnal and morning were decreased significantly 8 weeks after treatment in 87 patients（ P〈 0.05）. The percentage of patients with morning hypertension was significantly lower after treatment than before treatment（ 36. 78% vs. 68.97%,P 〈0.05）. Circadian rhythm was not significantly improved after treatment. The trough / peak ratio of the systolic and diastolic blood pressure were〉 50%,and smoothness index were〉 1. No serious adverse events were found. Conclusion： L-amlodipine maleate has a stable and long-lasting antihypertensive effect on essential hypertension with the comparable safety.