摘要
目的:探讨不同剂量维生素D对高龄高血压病患者血压晨峰及血压变异性的影响。方法:选取我院治疗的86例高血压合并维生素D不足或缺乏老龄患者,按随机数字表法等分为低剂量组和高剂量组,各43例,高剂量组给予骨化三醇胶丸,2次/d,0.5μg/次;低剂量组给予骨化三醇胶丸1次/d,0.25μg/次,疗程均为3个月。比较两组患者用药前与疗程结束后24 h的收缩压(SBP)与舒张压(DBP),血压变异性,血清25羟基维生素D[25(OH)D3]、血浆肾素活性(PRA)以及血压晨峰阳性发生率。结果:疗程结束后24 h,高剂量组患者的SBP和DBP远低于对照组,两者比较有显著性差异(P<0.05);高剂量组患者的血压变异性舒张压标准差(DSD)和收缩压标准差(SSD)远低于对照组,两者比较有显著性差异(P<0.05)。用药后25(OH)D3升高,且高剂量组远高于低剂量组,用药后PRA降低,且高剂量组远低于低剂量组,两者比较均有显著性差异(P<0.05)低剂量组患者的血压晨峰阳性发生率远高于高剂量组,两者比较有显著性差异(P<0.05)。结论:维生素D对高龄高血压合并维生素D缺乏患者,能有效降低血压和血压晨峰率,血压变异性也有所降低,调节肾素-血管紧张素-醛固酮系统。
Objective:To investigate the effects of different doses of vitamin D on morning blood pressure surge and blood pressure variability in elderly patients with hypertensive.Methods:86 elderly hypertensive patients of vitamin D deficiency or lack of vitamin D treated in our hospital were randomized into low-dose group and high-dose group,with 43 cases in each group.The high-dose group was given calcitriol capsules twice a day,0.5ug/time;while the low-dose group was given calcitriol capsules once/d,0.25ug/time,and the course of treatment for both group was 3 months.Systolic blood pressure(SBP)and diastolic blood pressure(DBP),blood pressure variability,serum 25-hydroxyvitamin D[25(OH)D3],plasma renin activity(PRA),and the incidence of morning surge positive blood pressure were compared between the two groups before and after the end of treatment.Results:At 24 hours after the end of treatment,SBP and DBP in the high-dose group were much lower than those in the control group,which were of significant differences between both groups(P<0.05);DSD and SSD in the high-dose group were lower than those of the control group,which were of statistical differences(P<0.05).After treatment,25(OH)D3 in both groups was elevated,but it was much higher than that of the low dose group.PRA decreased after treatment,but it was much lower in the high-dose group than that in the low-dose group.There was a significant difference between the two groups(P<0.05).The incidence of blood pressure morning surge in the low-dose group was much higher than that of the high-dose group,which was of significant.difference(P<0.05).Conclusions:Vitamin D can effectively reduce the blood pressure and blood pressure morning surge rate,blood pressure variability,and regulate the renin-angiotensin-aldosterone system in hypertensive patients with vitamin D deficiency.
作者
黄英俊
黄祖坚
朱玉红
陈家柱
潘杰
HUANG Yingjun;HUANG Zujian;ZHU Yuhong(Dept.of Cardiovascular Medicine,Yangchun Hospital of Traditional Chinese Medicine,Yangchun 529600,China)
出处
《华夏医学》
CAS
2019年第5期53-57,共5页
Acta Medicinae Sinica
