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目的探讨研究不同时间应用缬沙坦氢氯噻嗪片对非杓型高血压患者超声心动图参数及N末端脑钠肽前体(N-terminal brain natriuretic peptide precursor,NT-pro BNP)的影响。方法纳入74例1-2级新发高血压患者,随机分为晨起给药组、睡前服药组,分别于晨起或睡前服用缬沙坦氢氯噻嗪片(每片含缬沙坦80mg及氢氯噻嗪12.5mg)。所有病例治疗前及治疗24周后进行动态血压、超声心动图及NT-pro BNP的检测。结果治疗24周后,两组患者全天血压、左心室质量指数(Left Ventricular Mass Index,LVMI)、室间隔厚度(Interventricular Septal Thickness,IVST)、左心室后壁厚度(Left Ventricular Posterior Wall Thickness,LVPWT)、左室舒张末期内径(Lfet Ventricular End Diastolic Diameter,LVEDD)、等容舒张时间(Isovolumic Relaxation Time,IVRT)、早期心室充盈峰值速度与晚期心室充盈峰值速度比值(E/A)和左心房容积指数(Left Atrial Volume Index,LAVI)、NTpro BNP较治疗前均有改善,差异有统计学意义(P<0.05);左心室射血分数(Left Ventricular Ejection Fraction,LVEF)较用药前比较,差异无统计学意义(P>0.05)。治疗后两组之间血压、LVEF比较,差异无统计学意义(P>0.05),而睡前服用组其余超声心动图参数优和NT-pro BNP于晨起服药组,差异有统计学意义(P<0.05)。结论睡前服用缬沙坦氢氯噻嗪片较晨起服药可更为有效改善非杓型高血压患者左心室肥厚及舒张功能,逆转左心室重构,降低。
Objective To investigate the effects of valsartan hydrochlorothiazide tablets on echocardiographic parameters and N-terminal brain natriuretic peptide precursor (NT-pro BNP) in non-dipper hypertensive patients at different time points. Methods A total of 74 patients with grade 1-2 new-onset hypertension were randomly divided into early morning medication group and pre-sleep medication group. Valsartan hydrochlorothiazide tablets (each containing valsartan 80 mg and Hydrochlorothiazide 12.5 mg). All cases before treatment and after 24 weeks of treatment for ambulatory blood pressure, echocardiography and detection of NT-pro BNP. Results After 24 weeks of treatment, blood pressure, left ventricular mass index (LVMI), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT) ), Left ventricular end diastolic diameter (LVEDD), left ventricular end diastolic volume (LVEDD), IVRT, peak ventricular filling velocity (E / A) Left Atrial Volume Index (LAVI) and NTpro BNP were improved compared with before treatment, the difference was statistically significant (P <0.05); left ventricular ejection fraction (LVEF) than before treatment, the difference was not Statistical significance (P> 0.05). There was no significant difference in blood pressure and LVEF between the two groups after treatment (P> 0.05), while the rest echocardiographic parameters before going to bed and NT-pro BNP in the morning after taking the medicine group were significantly different P <0.05). Conclusions Taking valsartan hydrochlorothiazide before going to bed at bedtime may be more effective in improving left ventricular hypertrophy and diastolic function in non-dipper hypertensive patients and reversing left ventricular remodeling and lowering.