比索洛尔/氢氯噻嗪复方片对轻、中度原发性高血压患者血压昼夜节律的影响

目的：采用动态血压监测观察比索洛尔/氢氯噻嗪复方片（2.5mg/6.25mg,Lodoz）对轻、中度原发性高血压患者的血压昼夜节律的影响。方法：选择90例收缩压（SBP）〈180mmHg、舒张压（DBP）95～109mmHg的轻、中度原发性高血压患者,口服Lodoz共4周,用24h动态血压监测评价治疗4周后动态血压和血压昼夜节律变化。结果：（1）治疗4周后,“杓型”和“非杓型”组的24hSBP/DBP分别降低9.57/7.75mmHg和12.61/9.88mmHg,日间SBP/DBP分别降低10.59/8.20mmHg和10.91/8.00mmHg,“杓型”和“非杓型”组间的24h和日间SBP/DBP治疗前后差异无统计学意义（P〉0.05）。（2）“杓型”组夜间SBP/DBP降低6.12/5.65mmHg,“非杓型”组降低17.33/13.61mmHg,两组间差异显著（P〈0.01）。（3）“杓型”组的夜间SBP/DBP下降百分比治疗前后无显著性差异（P〉0.05）,血压昼夜曲线仍为“杓型”。“非杓型”组的SBP/DBP夜间下降百分比在治疗后显著增加（P〈0.01）,SBP/DBP的夜间下降百分比两组间比较,差异显著（P〈0.01）。结论：比索洛尔/氢氯噻嗪复方片（2.5mg/6.25mg/d）对“非杓型”组患者的夜间SBP/DBP降低作用较明显,有益于保持正常的血压昼夜节律。

Effects of combination of bisorpolol and hydrochlorothiazide on circadian blood pressure in the patients with mild to moderate essential hypertension

Objective：To investigate the effects of combination of bisorpolol（2.5mg）and hydrochlorothiazide（6.25mg）（Lodoz）on circadian blood pressure in patients with mild to moderate essential hypertension.Methods：After 2 weeks of placebo run-in period,90 hypertensive patients whose sitting diastolic blood pressure（DBP）was between 95 and 109mmHg while systolic blood pressure（SBP）below 180mmHg, were treated with Lodoz for 4 weeks.Ambulatory blood pressure monitoring was conducted at the end of placebo run-in period and to the end of 4th week.Results：① After treatment with Lodoz once-daily for 4 weeks,the 24-hour mean of SBP/DBP reduced 9.57/7.75 mmHg in＂dipper＂group and 12.61/9.88 mmHg in＂non-dipper＂group.The reductions of day-time SBP/DBP were 10.59/8.20 mmHg in＂dipper＂group and 10.91/8.00 mmHg in＂non-dipper＂group.There was no significant difference between the two groups（P〉0.05）.②The nocturnal blood pressure decreased 6.12/5.65mmHg in＂dipper＂group and 17.33/13.61mmHg in＂non-dipper＂group,which was significantly different between the two groups（P〈0.01）.③The percentage of nocturnal blood pressure reduction changed slightly,without significant difference compared with the baseline value in＂dipper＂group（P〉0.05）.There was significant increas of the percentage of nocturnal blood pressure reduction in＂non-dipper＂group（P〈0.01）,compared with that of pre-therapy.Conclusion：Lodoz once-daily can effectively reduced the nocturnal blood pressure,especially for hypertensive patients with＂non-dipper＂pattern of blood pressure,which is good for keeping the normal circadian blood pressure.