摘要
目的探讨不同时间服用氯沙坦治疗原发性高血压病晨峰现象的疗效及安全性。方法选取2011年2月—2013年8月滨海康达医院收治的具有晨峰现象的轻中度原发性高血压病患者186例,采用随机数字表法分为3组,晨服组62例,每日8:00左右服用氯沙坦50 mg;晚服组64例,每日20:00左右服用氯沙坦50 mg;对照组60例,给予除血管紧张素受体阻断药(ARB)与血管紧张素转化酶抑制剂(ACEI)以外的降压药物治疗,比较3组患者治疗前后平均收缩压(MSBP)、平均舒张压(MDBP)、最高收缩压(MAXSBP)及最高舒张压(MAXDBP)的变化,晨峰现象缓解率及不良反应发生率。结果治疗前,3组患者MSBP、MDBP、MAXSBP、MAXDBP比较,差异均无统计学意义(P>0.05)。治疗后,3组患者MSBP、MAXSBP、MAXDBP比较,差异均有统计学意义(P<0.05);其中晨服组、晚服组患者MSBP低于对照组,晚服组患者MAXSBP和MAXDBP低于对照组,晚服组患者MSBP低于晨服组(P<0.05)。晨服组患者晨峰现象缓解率为32.3%(20/62),晚服组为76.6%(49/64),对照组为26.7%(16/60),3组比较差异有统计学意义(χ2=37.839,P<0.001),其中晚服组患者晨峰现象缓解率高于晨服组和对照组(χ2=24.952、30.911,P<0.001)。晨服组患者不良反应发生率为53.2%(33/62),晚服组为53.1%(34/64),对照组为70.0%(42/60),3组比较差异无统计学意义(χ2=4.743,P=0.093)。结论晚上服用氯沙坦更能有效地控制原发性高血压病晨峰现象,并不增加不良反应的发生,为更合理的治疗方案。
Objective To investigate the efficacy and safety of losartan at different time points in the treatment of morning blood pressure surge（ MBPS） in patients with primary hypertension. Methods We enrolled 186 patients with light and moderate primary hypertension and MBPS who were admitted into Binhaikangda Hospital from February 2011 to August2013. Using random number table method,we divided the patients into three groups. We assigned 62 patients into morning group in which 50 mg losartan was administrated at 8： 00, assigned 64 patients into evening group in which 50 mg losartan was administrated at 20： 00 and assigned 60 patients into control group in which hypotensive drugs apart from ARB and ACEI were administrated. Comparison was made among the three groups in the changes of MSBP,MDBP,MAXSBP and MAXDBP after treatment,the rate of MBPS alleviation and the incidence rate of adverse reaction. Results Before treatment,the three groups were not significantly different（ P 〉0. 05） in MSBP,MDBP,MAXSBP and MAXDBP. After treatment,the three groups were significantly different（ P〈 0. 05） in MSBP,MAXSBP and MAXDBP; morning group and evening group were lower（ P 〈0. 05）than control group in MSBP,evening group was lower（ P 〈0. 05） than control group in MAXSBP and MAXDBP,and evening group was lower（ P〈 0. 05） than morning group in MSBP. The rates of MBPS alleviation of morning group,evening group and control group were 32. 3%（ 20 /62）,76. 6%（ 49 /64） and 26. 7%（ 16 /60） respectively, with no significant differences among the three groups（ χ2= 37. 839,P 0. 001）; the evening group was higher than morning group and control group in the rate of MBPS alleviation（ χ2= 24. 952,30. 911,P〈 0. 001）. The rates of adverse reaction of morning group,evening group and control group were 53. 2%（ 33 /62）,53. 1%（ 34 /64） and 70. 0%（ 42 /60） respectively,with no significant differences among the three groups（ χ2= 4. 743,P = 0. 093）. Conclusion The evening administration
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第32期3973-3976,共4页
Chinese General Practice
关键词
高血压
氯沙坦
治疗结果
药物毒性
Hypertension
Losartan
Treatment outcome
Drug toxicity
