替米沙坦不同给药时间对高血压患者血压监测参数及超敏C反应蛋白的影响

Effects of Different Administration Time of Telmisartan on Blood Pressure Monitoring Parameters and High-sensitivity C-reactive Protein in Patients with Hypertension

目的探讨替米沙坦不同给药时间对高血压患者血压监测参数及超敏C反应蛋白(hs-CRP)的影响。方法选取2019年8月-2020年8月天津市滨海新区海滨人民医院心脏内科收治的112例高血压患者,按照随机数字表法分为对照组与观察组,各56例。两组患者均采用替米沙坦治疗,对照组于清晨给药,观察组于夜间给药,比较两组动态血压监测参数、晨峰血压、夜间血压下降百分率(PER)、血压类型分布、hs-CRP、动脉硬化指数(AASI)及不良反应。结果两组治疗后动态血压监测参数均低于治疗前,且观察组夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)均低于对照组(P<0.05);观察组治疗后晨峰血压低于对照组,PER高于对照组(P<0.05);两组治疗后杓型高血压患者占比增加,非杓型高血压患者占比减少,且观察组杓型高血压患者占比高于对照组,非杓型高血压占比低于对照组(P<0.05);两组治疗后hs-CRP、AASI均低于治疗前,且观察组低于对照组(P<0.05)。结论替米沙坦夜间给药可降低高血压患者的夜间血压水平,恢复血压昼夜节律,纠正血压异常类型,同时降低hs-CRP及AASI指标,其效果优于早间服药。

Objective To investigate the effects of different administration times of telmisartan on blood pressure monitoring parameters and high-sensitivity C-reactive protein(hs-CRP)in patients with hypertension.Methods A total of 112 hypertensive patients who were admitted to the Department of Cardiology,Haibin People's Hospital of Tianjin Binhai New Area from August 2019 to August 2020 were selected and divided into a control group and an observation group according to a random number table,with 56 cases in each group.Both groups of patients were treated with telmisartan.The control group was administered in the morning and the observation group was administered at night.The ambulatory blood pressure monitoring parameters,morning peak blood pressure,nocturnal blood pressure drop percentage(PER),blood pressure type distribution,hs-CRP,arteriosclerosis index(AASI)and adverse reactions were compared between the two groups.Results The ambulatory blood pressure monitoring parameters of the two groups after treatment were lower than those before treatment,and the nocturnal mean systolic blood pressure(nSBP)and nocturnal mean diastolic blood pressure(nDBP)of the observation group were lower than those of the control group(P<0.05).The morning peak blood pressure in the observation group was lower than that in the control group,and PER was higher than that in the control group(P<0.05).After treatment,the proportion of patients with dipper hypertension increased and the proportion of patients with non-dipper hypertension decreased in the two groups,and the proportion of patients with dipper hypertension in the observation group was higher than that in the control group,while the proportion of patients with non-dipper hypertension was lower than that in the control group(P<0.05).After treatment,hs-CRP and AASI in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).Conclusion Night-time administration of telmisartan can reduce the nocturnal blood pressure level of patients with hypertension,restore the circadian rhythm of blood pressure,correct the type of abnormal blood pressure,and reduce hs-CRP and AASI indexes.The effect is better than that of early medication.