不同时间服用左旋氨氯地平对老年高血压合并心衰患者的影响

目的:采取不同时间给药的方法治疗老年高血压合并心衰患者,观察两组患者动态血压参数的变化及左室功能的变化。方法:选取2009年1月～2011年6月在我科治疗的高血压合并轻度心衰的患者120例,随机分为白天组和夜间组各60例,两组患者均使用1次/d口服左旋氨氯地平2.5～5mg,观察两组患者治疗前后动态血压参数的变化及左室舒张功能的变化。结果:自治疗第4周开始,白天组及夜间组均能较好的控制血压,至治疗12周,血压均能控制在正常范围内,且呈现逐步降低趋势;组内比较发现,自第4周至第12周,两组患者的dSBP、dDBP差异均不明显(P>0.05)。而两组患者的nSBP、nDBP差异显著(P<0.05)。治疗12周后,两组患者左室舒张早期血流峰值流速及舒张早期充盈时间差异显著(P<0.05)。治疗后两组患者杓型血压分别为10例及27例,有显著差异(P<0.05)。结论:夜间组患者服用左旋氨氯地平片能够更好的控制夜间血压,且更多的患者恢复了血压的节律性,能够更好的保护靶器官,减少心血管事件的发生率。

Effects comparison of amlodipine taken at different time for elderly patients with hypertension complicated with heart failure

Objective: To observe influence of administration time on the effects of amlodipine for elderly patients with hypertension complicated with heart failure.Methods:A total of 120 cases hypertension complicated with mild heart failure that admitted to our hospital during January 2009 and June 2011 were randomly divided into day administration group and night administration group with 60 cases in each group.Dosage of amlodipine was 2.5 ~ 5 mg,once per day.Ambulatory blood pressure parameters and the changes of left ventricular diastolic function were observed and compared between the two groups.Results:Started from the 4th week of treatment,both groups showed well controlled blood pressure.Blood pressure was at normal level till the 12th week of treatment showing a decline tendency.From week 4 to week 12,there was no significant difference in dSBP and dDBP,while difference in nSBP、nSBP was significant(P<0.05).After 12 weeks of treatment,significant differences in left ventricular early diastolic peak velocity and early diastolic filling time were found(P<0.05).Ten and 7 cases of dipper type blood pressure were found respectively in the two groups,showing significant difference(P<0.05).Conclusions:Night administration of amlodipine tablets shows better control effects of blood pressure,and make most patients restore normal blood pressure rhythm,thus can protect target organs,and reduce the rate of cardiovascular events.