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中国临床研究英文版:2024,37(1):66-69
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夜间高血压患者不同组合降压药物治疗的疗效
(湖南医药学院第一附属医院心血管内科,湖南 怀化 418000)
Efficacy of different combinations of antihypertensive drugs in patients with nocturnal hypertension
(Cardiovascular Department,The First Affiliated Hospital of Hunan University of Medicine, Huaihua, Hunan 418000, China)
摘要
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Received:April 22, 2023   Published Online:January 20, 2024
中文摘要: 目的 观察夜间高血压(NH)患者不同组合降压药物的疗效,为临床工作提供参考。 方法 采用横断面研究方法,收集2021年1月至2022年12月在湖南医药学院第一附属医院体检并经动态血压监测诊断为NH患者的临床资料。根据不同类型用药治疗情况,将NH患者分为单药组、双药联合组和多药联合组,单药组应用血管紧张素转换酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)或钙拮抗剂,双药联合组应用ACEI/ARB联合钙拮抗剂,多药联合组应用ACEI/ARB、钙拮抗剂、β受体阻滞剂和利尿剂中的任意三种或四种联合。对三组患者的临床资料进行分析比较。 结果 NH患者共829例,其中单药组294例占35.46%,双药联合组400例占48.25%,多药联合组135例占16.29%。 经药物治疗6个月后,单药组、双药联合组及多药联合组患者的夜间收缩压(NSBP)、夜间舒张压(NDBP)较治疗前显著下降(P<0.05),其中双药联合组明显低于单药组和多药联合组,但单药组和多药联合组组间比较差异无统计学意义(P>0.05);NSBP和NDBP下降幅度双药联合组(21.75%,20.06%)显著大于单药组(17.60%,15.26%)和多药联合组(18.23%,16.51%,P<0.05)。 结论 三种用药方式均能有效控制夜间血压,但ACEI/ARB联合钙拮抗剂降低夜间血压效果更优。
Abstract:Objective To observe the efficacy of different combinations of antihypertensive drugs in patients with nocturnal hypertension (NH), and provide reference for clinical work. Methods A cross-sectional study was used to collect clinical data of NH patients diagnosed through ambulatory blood pressure monitoring during physical examinations at the First Affiliated Hospital of Hunan University of Medicine from January 2021 to December 2022. According to the different motheds of medication treatment for patients, NH patients were divided into single-drug group, dual-drug group and multi-drug group.Angiotensin converting enzyme inhibitor (ACEI)/ angiotensin Ⅱ receptor antagonist (ARB) or calcium antagonist was used in single-drug group, ACEI/ARB combined with calcium antagonist were used in double-drug group, and any three or four combinations of ACEI/ARB, calcium antagonists, β-blockers and diuretics were used in multi-drug group.The clinical data of the three groups of patients were analyzed and compared. Results There were 829 patients with NH, including 294 cases (35.46%) in single-drug group, 400 cases (48.25%) in dual-drug group and 135 cases (16.29%) in multiple-drug group. After 6 months of drug treatment, the nocturnal systolic blood pressure (NSBP) and nocturnal diastolic blood pressure (NDBP) of patients in single-drug group, dual-drug group and multi-drug group showed significant differences compared to before treatment (P<0.05),among them, the NSBP and NDBP of patients in dual-drug group were significantly lower than those in single-drug group and multi-drug group, but there was no significant difference between the latter two groups (P>0.05). The decreases in NSBP and NDBP in dual-drug group (21.75%, 20.06%) were greater than those in single-drug group (17.60%, 15.26%) and multi-drug group (18.23%, 16.51%, P<0.05), respectively. Conclusion All three motheds of medication treatment can effectively control nocturnal blood pressure, but ACEI/ARB combined with calcium antagonist are more effective in lowering nocturnal blood pressure.
文章编号:     中图分类号:R544.1    文献标志码:A
基金项目:湖南省卫生健康委科研计划课题(202103011492);湖南省科技厅创新平台项目(2020SK4020);湖南省卫生健康委适宜技术推广项目(202218015804)
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