不同给药时间对非杓型高血压控制及尿微量白蛋白的影响

Influences of Administration Time of Antihypertensive Agents on Blood Pressure and Microalbuminuria

目的 探讨降压药物的不同用药时机对患者血压控制情况及尿微量白蛋白的影响。方法 选取2015年1月—2016年1月在我院就诊的非杓型高血压患者130例,随机分为观察组和对照组,每组各65例。观察组在晚上20：00~21：00点服药,对照组在早上6：00~7：00点服药,两组患者均治疗12周。分别于服药前后进行24 h动态血压监测,记录并比较两组患者24 h平均收缩压（24 h-SBP）、24 h平均舒张压（24 h-DBP）、24 h平均动脉压（24 h-MMAP）、日间平均收缩压（d-SBP）、日间平均舒张压（d-DBP）、日间平均动脉压（d-MMAP）、夜间平均收缩压（n-SBP）、夜间平均舒张压（n-DBP）、夜间平均动脉压（n-MMAP）,并比较两组患者服药前后血压节律及24 h尿微量白蛋白水平变化情况。结果 观察组有58例患者完成研究,对照组有57例患者完成研究。治疗前,两组患者24 h-SBP、24 h-DBP、24 h-MMAP、d-SBP、d-DBP、d-MMAP、n-SBP、n-DBP、n-MMAP的水平差异均无统计学意义（P〉0.05）。治疗后,两组患者的各指标均较治疗前明显降低（P〈0.05）,且观察组较对照组降低更为显著（P〈0.05）。治疗后,观察组65.5%的患者转变为杓型血压,对照组50.9%的患者转变为杓型血压,两组血压节律的转变无统计学意义（P〉0.05）。治疗前,观察组和对照组的尿微量白蛋白差异无统计学意义（P〉0.05）;治疗后,两组患者尿蛋白均较各组治疗前明显降低（P〈0.05）,组间比较观察组较对照组降低更为明显（P〈0.05）。结论 非杓型高血压患者晚上服药,更有助于控制昼夜血压,减少尿微量白蛋白的排泄。

OBJECTIVE To study the influences of antihypertensive agents＇ administration time on blood pressure and microalbumin- uria（MAU）. METHODS 130 patients diagnosed with nondipping hypertensions from Jan 2015 to Jan 2016 were selected and randomly divided into 2 groups, with 65 cases in each group. The observation group was administrated at 20：00 ~ 21：00, while the control group was treated at 6：00 ~ 7：00. Both groups were treated for 12 weeks. The ABPM and MAU were implemented and compared between 2 groups before and after treatment. RESULTS 58 and 57 patients completed the study, respectively. There were no differences in 24h-SBP, 24h-DBP, 24h-MMAP, d-SBP, d-DBP, d-MMAP, n-SBP, n-DBP, n-MMAP and MAU between two groups before treatment（P〉0.05）. After treatment, all above indexes were significantly decreased in two groups （P〈0.05）, and there were signifi- cant differences between two groups（P〈0.05）. 65.5% and 50.9% cases turned to be dipper blood pressure patterns in observation and control group after treatment, respectively. The difference between blood pressure patterns was not significant （P〉0.05）. CON- CLUSIONS Administration at night could help control blood pressure and decrease mieroalbuminuria more effectively.