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目的探讨氨氯地平联合美托洛尔或贝那普利对难治性高血压患者血压变异性的影响。方法选取2016年1月至2017年1月在方城县中医院进行治疗的难治性高血压患者82例,随机分为对照组和观察组,每组41例。对照组实施氨氯地平联合贝那普利治疗,观察组采用氨氯地平联合美托洛尔治疗,两组患者均进行16周的治疗。比较两组患者血压变异性及生活质量。结果治疗前,观察组白天舒张压变异性(d DBPV)、白天收缩压变异性(d SBPV)、夜晚舒张压变异性(DBPV)、夜晚收缩压变异性(nSBPV)、24 h舒张压变异性(24 hDBPV)、24 h收缩压变异性(24 h SBPV)指标与对照组比较,差异无统计学意义(P>0.05);治疗16周结束时,观察组dSBPV、dDBPV、nSBPV、nDBPV、24 hSBPV、24 hDBPV明显低于对照组,差异有统计学意义(P<0.05);治疗16周后,观察组社会功能(83.27±5.04)分、情感状态(81.54±6.98)分、躯体供能(82.57±9.38)分、睡眠状况(81.24±7.16)分、躯体感觉(80.28±6.61)分、健康感觉(81.24±7.86)分明显优于对照组(74.87±4.13)分、(73.25±3.12)分、(72.23±4.72)分、(71.49±3.75)分、(72.23±3.51)分、(73.25±3.11)分,差异有统计学意义(P<0.05)。结论与氨氯地平联合贝那普利治疗相比,氨氯地平联合美托洛尔可更好的减少难治性高血压患者的血压变异性,改善患者生活质量。
Objective To investigate the effect of amlodipine combined with metoprolol or benazepril on blood pressure variability in patients with refractory hypertension. Methods 82 patients with refractory hypertension treated in Fangcheng Hospital of Traditional Chinese Medicine from January 2016 to January 2017 were randomly divided into control group and observation group, 41 cases in each group. The control group was treated with amlodipine combined with benazepril. The observation group was treated with amlodipine combined with metoprolol. Both groups were treated for 16 weeks. Blood pressure variability and quality of life were compared between the two groups. Results Before treatment, the d DBPV, d SBPV, DBPV, nSBPV and 24 h diastolic variability (24 h DBPV) and 24 h SBPV (24 h SBPV) were not significantly different from those of the control group (P> 0.05). At the end of 16 weeks, the dSBPV, dDBPV, nSBPV, nDBPV, hSBPV, 24h hDBPV was significantly lower than the control group, the difference was statistically significant (P <0.05); after 16 weeks of treatment, the social function (83.27 ± 5.04), emotional status (81.54 ± 6.98) 82.57 ± 9.38), sleep condition (81.24 ± 7.16), somatosensory (80.28 ± 6.61), and healthy feeling (81.24 ± 7.86) were significantly better than the control group (74.87 ± 4.13) and (73.25 ± 3.12) points respectively , (72.23 ± 4.72) points, (71.49 ± 3.75) points, (72.23 ± 3.51) points and (73.25 ± 3.11) points respectively. The difference was statistically significant (P <0.05). Conclusion Amlodipine combined with metoprolol can better reduce the variability of blood pressure in patients with refractory hypertension and improve the quality of life of patients with amlodipine combined with benazepril treatment.