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贝尼地平对清晨高血压患者血压昼夜节律、血压变异性及心脏结构的影响
作者:董艳梅  颜雪芸  宋琴 
单位:上海市静安区市北医院, 上海 200435
关键词:贝尼地平 清晨高血压 血压变异性 心脏结构 
分类号:R972.4
出版年·卷·期(页码):2020·39·第三期(340-345)
摘要:

目的:探讨贝尼地平对清晨高血压患者血压昼夜节律、血压变异性及心脏结构的影响。方法:选取本院心血管内科2015年7月到2016年7月收治的142例原发性高血压患者,按照随机数字表分为贝尼地平组和氨氯地平组,各71例。两组在治疗前和治疗2个月后采用便携式动态血压仪测量24 h动态血压;6个月后超声检测室间隔厚度(IVST)、左室后壁厚度(PWT)和左心室内径值,计算左心室质量指数(LVMI)。结果:治疗后两组血压较治疗前均显著降低(P<0.05),但两组血压差异无统计学意义(P>0.05)。治疗2个月后两组血压标准差较治疗前均显著降低(P<0.05);虽然两组白昼平均血压、夜间平均血压和24 h平均血压标准差差异均无统计学意义(P>0.05),但贝尼地平组清晨平均血压标准差显著低于氨氯地平组(P<0.05)。治疗前后两组心脏IVST、PWT和LVMI指标变化差异均无统计学意义(P>0.05),治疗后两组心脏IVST、PWT和LVMI等指标差异也均无统计学意义(P>0.05)。结论:贝尼地平和氨氯地平均能降低清晨高血压患者24 h、夜间和日间血压,降低血压变异性,且不增加左心室肥厚程度,贝尼地平在降低清晨收缩压变异性方面优于氨氯地平。

Objective: To explore the effect of benidipine on blood pressure circadian rhythm, blood pressure variability and cardiac structure in patients with early morning hypertension.Methods: 142 patients with essential hypertension who were admitted to the Department of Cardiology from July 2015 to July 2016 were randomly divided into benidipine group and amlodipine group according to a random number table, 71 cases in each. 24 hours ambulatory blood pressure was measured before and 2 months after treatment with a portable ambulatory blood pressure monitor; after 6 months, the interventricular septal thickness (IVST), left ventricular posterior wall thickness (PWT), and left ventricular inner diameter(LVID) were measured by ultrasound. LVID value and left ventricular mass index (LVMI) were also calculated. Results: The blood pressure of both groups after treatment was significantly lower than thatbefore treatment (P<0.05), but there was no significant difference in blood pressure between the two groups after treatment (P>0.05). After 2 months of treatment, the standard deviation of blood pressure in both groups was significantly lower than that before treatment (P<0.05). However, there was no significant difference in standard deviation of mean blood pressure, nighttime blood pressure, and 24-hour mean blood pressure between the two groups after treatment (P>0.05), while the mean blood pressure standard deviation of the benidipine group was significantly lower than that of the amlodipine group (P<0.05). There were no significant changes in IVST, PWT, and LVMI before and after treatment between the two groups (P>0.05). There was no significant difference in IVST, PWT and LVMI between the two groups after treatment (P>0.05).Conclusion: Benridipine and amlodipine can reduce blood pressure, nighttime and daytime blood pressure in patients with early morning hypertension, reduce blood pressure variability, without increasing the degree of left ventricular hypertrophy. Benedipine is superior to amlodipine in reducing variability of early morning systolic blood pressure.

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