琥珀酸美托洛尔缓释片和盐酸贝那普利片服药时间对非杓型高血压患者血压的影响

目的探讨不同时间服用琥珀酸美托洛尔缓释片和盐酸贝那普利片对原发性轻中度非杓型高血压患者血压的影响。方法将60例1、2级非杓型高血压患者，随机分为A组（早上顿服组）、B组（早晚分服组），连续治疗8周。观察治疗前后血压水平、清晨高峰及血压昼夜节律的影响。结果动态血压监测结果显示，两组患者的24h平均收缩压（24hSBP）、24h平均舒张压（24hDBP）、昼问平均收缩压（dSBP）、昼间平均舒张压（dDBP）、夜间平均收缩压（nSBP）、夜间平均舒张压（nDBP）水平与治疗前比较有明显下降（P〈0．05），B组的nSBP、nDBP达标率明显高于A组（P〈0．01）。清晨血压方面，B组患者清晨SBP和DBP显著低于A组（P〈0．05）。在血压昼夜节律纠正方面，A组将非杓型纠正为杓型的比例为16．7％，B组将非杓型纠正为杓型的比例为63．3％，差异有高度统计学意义（P〈0．01）。结论对于原发性轻中度非杓型高血压患者，联合服用琥珀酸美托洛尔缓释片和盐酸贝那普利片可以有效控制血压；早晚分次给药可以较好地纠正清晨高血压和夜间血压的高负荷状态，有利于血压昼夜节律由非杓型转变为杓型。

Effects of time of taking Metoprolol Succinate Sustained-Release Tablets and Benazepril Hydrochloride Tablets on non dipper blood pressure in hypertensive patients

Objective To investigate the influence of different time of taking Metoprolol Succinate Sustained-Release Tablets and Benazepril Hydrochloride Tablets on primary mild and moderate non dipper blood pressure in hypertensive patients. Methods 60 cases of patients of grade 1, grade 2 non dipper type hypertension were randomly divided into group A （morning together group）, group B （morning and evening to take separately group）, a total of 8 weeks of treat- ment. Before and after the treatment of ambulatory blood pressure monitoring, the effects of drugs on blood pressure levels, morning peak and circadian rhythm of blood pressure were observed. Results The ambulatory blood pressure monitoring results, two groups of patients with 24 h SBP, 24 h DBP, dSBP, dDBP, nSBP, nDBP levels before and after treatment decreased significantly （P 〈 0.05）, nSBP, nDBP compliance rate of group B was significantly higher than group A （P 〈 0.01）. Morning blood pressure, SBP and DBP in group B was significantly lower than that in group A （P 〈 0.05）. In the circadian rhythm of blood pressure correction, group A would be non dipper to correct for the dipper was 16.7%, group B of non dipper to correct for the dipper was 63.3%, the difference was statistically significant （P 〈 0.01）. Conclusion For the patients with primary mild and moderate non dipper type hypertension, combined use of Metoprolol Succinate Sustained-Release Tablets and Benazepril Hydrochloride Tablets can effectively control blood pressure; morning and evening medication can effectively decrease hypertension in morning and night high load of blood pres- sure, blood pressure circadian rhythm is conducive to the transformation from non dipper as dipper.