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目的:评价硝苯地平控释片用于治疗老年冠状动脉粥样硬化患者血压变异性(blood pressure variability,BPV)的影响。方法:选取2013年1月—2014年1月间诊治的老年冠状动脉粥样硬化患者89例,将其分为对照组(44例)和观察组(45例),对照组患者均给予阿托伐他汀和抗血小板凝聚及对症支持等药物治疗,观察组患者在对照组治疗基础上均给予硝苯地平控释片治疗;两组患者治疗1周,监测24 h动态血压,比较治疗前后各BPV指标,即24 h收缩压变异(24 h SSD),白昼收缩压变异(d SSD),夜间收缩压变异(n SSD),24 h舒张压变异(24 h DSD),白昼舒张压变异(d DSD),夜间舒张压变异(n DSD),收缩压(SBP)和舒张压(DBP)变化情况。结果:观察组患者治疗后收缩压变异性指标(24 h SSD、d SSD、n SSD)均明显低于治疗前和对照组治疗后;两组患者治疗后各变异性指标经比较其差异有统计学意义(P<0.05);两组患者舒张压各变异性指标(24 h DSD、d DSD、n DSD)经比较其差异无统计学意义(P>0.05);观察组患者治疗后收缩压较治疗前明显下降(P<0.05),而对照组患者治疗前后收缩压和舒张压经比较其差异无统计学意义(P>0.05)。结论:监测血压变异性,控制24 h血压值对老年冠状动脉粥样硬化患者合理使用硝苯地平控释片具有重要临床意义。
Objective: To evaluate the effect of nifedipine controlled release tablets on blood pressure variability (BPV) in elderly patients with coronary atherosclerosis. Methods: A total of 89 elderly patients with coronary atherosclerosis who were diagnosed and treated between January 2013 and January 2014 were divided into control group (44 cases) and observation group (45 cases). Patients in the control group The patients in the observation group were given nifedipine controlled release tablets on the basis of the treatment of the control group. The patients in both groups were treated for 1 week, and the ambulatory blood pressure was monitored for 24 hours. The levels of BPV The 24 h SSD, d SSD, n SSD, 24 h DSD, d DSD, ), N diastolic pressure variation (n DSD), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results: The indexes of variability of systolic blood pressure (24 h SSD, d SSD, n SSD) in the observation group were significantly lower than those before treatment and after treatment in the control group. The differences of the variability index between the two groups after treatment were statistically significant (P <0.05). There was no significant difference in the indexes of variability of diastolic blood pressure (24 h DSD, d DSD, n DSD) between the two groups (P> 0.05). The systolic blood pressure Before treatment, there was a significant decrease (P <0.05), but there was no significant difference in systolic and diastolic blood pressure before and after treatment in the control group (P> 0.05). CONCLUSION: Monitoring blood pressure variability and controlling blood pressure for 24 h have important clinical significance for the rational use of nifedipine GITS in elderly patients with coronary atherosclerosis.