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目的观察替米沙坦48h血压控制的效果和对动脉硬化指数(AASI)的影响。方法轻、中度原发性高血压患者71例,经过2wk的清洗期后接受口服替米沙坦,80mg,qd,治疗8wk。治疗前接受24h动态血压监测,治疗8wk后接受48h动态血压监测,比较治疗前后血压以及AASI的变化。结果完成有效病例数60例。治疗8wk时,末次服药后d1的平均SBP和DBP分别为(134±s14)mmHg、(87±8)mmHg,末次服药后d2的平均SBP和DBP分别为(135±14)mmHg、(88±8)mmHg,均比治疗前[(141±14)mmHg、(92±8)mmHg]显著下降(P<0.01);治疗的总有效率为60%(36/60),末次服药后d2有效率仍达50%(30/60)。对治疗有效的病例进行分析:SBP和DBP下降的平滑指数(SI)分别为1.02和0.89;清晨高血压患者的比例治疗前69%(25/36),治疗后下降至39%(14/36)(P<0.01),而所有患者夜间平均DBP均在60mmHg以上。治疗后AASI有下降趋势,但无显著差异(0.48±0.15vs.0.44±0.18,P>0.05),AASI的变化与脉压的改变密切相关。结论替米沙坦80mg能够持续48h控制轻、中度原发性高血压,降低清晨高血压,夜间血压无过度下降,对AASI的影响尚需进一步随访观察。
Objective To observe the effect of telmisartan 48h on blood pressure control and its effect on arteriosclerosis index (AASI). Methods Totally 71 patients with mild to moderate essential hypertension received telmisartan 80 mg qd for 8 weeks after 2wk washout period. Before treatment, 24h ambulatory blood pressure monitoring was performed. After 8 weeks of treatment, ambulatory blood pressure monitoring was performed at 48 hours. The changes of blood pressure and AASI before and after treatment were compared. Results The number of effective cases completed 60 cases. After 8 wk of treatment, the average SBP and DBP of d1 after the last dose were 134 ± s14 mmHg and 87 ± 8 mmHg, respectively. The mean SBP and DBP of d2 after the last dose were (135 ± 14) mmHg and (88 ± 8) mmHg were significantly lower than those before treatment [(141 ± 14) mmHg, (92 ± 8) mmHg] (P <0.01). The total effective rate was 60% (36/60) Efficiency is still up to 50% (30/60). The treatment-effective cases were analyzed: the smoothed indices (SI) of SBP and DBP decline were 1.02 and 0.89 respectively; the proportion of early morning hypertension was 69% (25/36) before treatment, and decreased to 39% after treatment (14/36 ) (P <0.01), while all patients had average nighttime DBP above 60 mmHg. There was a trend of decrease in AASI after treatment, but there was no significant difference (0.48 ± 0.15 vs.0.44 ± 0.18, P> 0.05). The change of AASI was closely related to the change of pulse pressure. Conclusion Telmisartan 80mg can be sustained 48h control of mild to moderate essential hypertension, reduce early morning hypertension, no significant drop in night blood pressure, the impact of AASI needs further follow-up observation.