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目的:研究不同时间联合使用非洛地平和替米沙坦对高血压患者血压昼夜节律的影响及对高血压左室肥厚的逆转作用。方法:将入选的86例高血压并发左室肥厚的患者随机分为2组,A组清晨顿服非洛地平和替米沙坦,B组清晨服用非洛地平,晚间服用替米沙坦,服药前及服药后每隔4周时分别测定患者诊室血压和24 h动态血压,测定用药前及用药36周时舒张期室间隔厚度(LVST),左室后壁厚度(LPWT)及舒张期左室内径(LVDd),并计算出心室重量(LVMT)。结果:2组用药后各时点收缩压及舒张压均低于用药前。B组夜间平均收缩压、夜间平均舒张压、晨峰血压升高程度、清晨收缩压、清晨舒张压、清晨脉压均较A组低。并且治疗36周后,B组的LVDd,LVST,LPWT均较A组减小(P<0.05)。结论:不同时间联合使用非洛地平和替米沙坦比清晨同时联合使用非洛地平和替米沙坦更能降低夜间血压、遏制清晨血压过度升高,改善高血压患者血压昼夜节律,并且在逆转左室肥厚方面,更有优势。
OBJECTIVE: To study the effects of combined use of felodipine and telmisartan on the circadian rhythm of blood pressure and the reversal of left ventricular hypertrophy in patients with hypertension. Methods: A total of 86 patients with hypertension complicated with left ventricular hypertrophy were randomly divided into two groups. Group A was treated with felodipine and telmisartan in the morning, group B took felodipine in the morning, telmisartan was taken in the evening, Patient’s office blood pressure and 24-hour ambulatory blood pressure were determined before treatment and every 4 weeks after taking the medicine. The left ventricular posterior wall thickness (LVWT), diastolic left ventricular wall thickness LVDd was calculated and ventricular weight (LVMT) was calculated. Results: The systolic blood pressure and diastolic blood pressure of the two groups were all lower than those before medication. Group B night average systolic blood pressure, nighttime mean diastolic blood pressure, morning peak blood pressure, early systolic blood pressure, early diastolic blood pressure, early pulse pressure were lower than the A group. After 36 weeks of treatment, the LVDd, LVST and LPWT in group B were lower than those in group A (P <0.05). CONCLUSIONS: The combination of felodipine and telmisartan at different periods of time compared with the combination of felodipine and telmisartan in the early morning can reduce nocturnal blood pressure, halt the excessive increase of morning blood pressure and improve the circadian rhythm of blood pressure in hypertensive patients, Reverse left ventricular hypertrophy, more advantages.