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【摘要】 目的 观察高血压患者应用甲磺酸氨氯地平前后血压昼夜节律变化及高血压药物时间治疗的血压控制情况并分析影响因素。方法 收集2年来我科住院的高血压患者200例,根据动态血压监测结果将血压昼夜节律分为杓型,非杓型,反杓型及超杓型,按类型进行时间给药,随访2个月进行分析。结果 入选病例中,正常血压节律87例,占43�5%;异常血压节律113例,占56�5%,其中非杓型占34�5%,反杓型占20%,超杓型占2%,中青年以正常血压节律为主,老年人以异常血压节律居多,治疗2个月,血压达标率72�5%,有71�68%的异常血压节律转为正常血压节律。结论 高血压患者应重视血压节律的检测,强化高血压药物的时间治疗学。�
【关键词】
甲磺酸氨氯地平 ;高血压;动态血压检测;时间治疗学;血压昼夜节律
Amlodipine Mesylate For The Day And Night Regular Effect Of The Hypertensive Patients
LIN Tong�mei, GUO Xin�sheng.
Sixth People’s Hospital of Anyang,Henan 45500,China
【Abstract】 Objective To observe amlodipine mesylate for the day and night regular effect and blood pressure control of the time treatment and its influencing factors in hypertensive patients。Methods 200 cases in our department during the last 2 years were selected,with blood pressure monitoring,circadian blood pressure profile was divided into dipping,non�dipping,reverse�dipping and extreme�dipping,time take medicine accordance with type,2 month observe。Results In all the cases,87(43�5%)showed normal circadian blood pressure profile and 113(56�5%)showed abnormal circadian blood pressure profile(34�5% of non�dipping,20% of reverse�dipping and 2% of extreme�dipping)。normal circadian blood pressure profile is more in middle�younger old than older。abnormal circadian blood pressure profile is more in older than it。2 month treatment 72�5% of blood pressure up to the standard,71�68% of abnormal circadian blood pressure are changed normal circadian blood pressure。 Conclusion Blood pressure monitoring should be emphasized in hypertensive patients。Time�treatmenology of hypertensive medicine be intensified。�
【Key words】
Amlodipine mesylate;Hypertension;Time�treatmentology;Ambulatory blood pressure monitoring;Circadian blood pressure profile
氨氯地平作为新一代的钙通道阻滞剂,具有阻止钙离子进入细胞膜,直接舒张血管平滑肌细胞,而起到扩张血管,降血压的作用。高血压是引起心脑血管疾病的重要危险因素,随着对高血压研究的深入,人们发现,不但血压水平与靶器官损害有关��[1]�,血压昼夜节律紊乱同样可导致或加重靶器官的损害��[2]�。因此,全面控制血压日益引起人们的重视,本文根据高血压患者血压昼夜节律变化,选择合适药物和适当时间给药,进行个体化治疗,以达到24 h控制血压,维持正常血压节律的目的。�
1 临床资料�
选择2006年1月至2007年8月曾在我科住院的部分高血压患者共200例,其中,男120例,女80例;年龄 3 结果�
按照夜间血压下降率的计算公式,观察血压波动的昼夜节律,结果发现:正常血压节律即杓型血压87例,占43�5%(87/200);异常血压节律113例,占56�5%(113/200),其中非杓型34�5%(69/200),反杓型20%(40/200),超杓型2%(4/200)。按年龄分组:
