美乐托宁对睡眠剥夺相关性高血压患者血压的影响

目的观察美乐托宁对睡眠剥夺相关性高血压患者血压的影响及其血压变化是否与睡眠改变有关。方法采用配对比较法，将人选患者随机分为2组[治疗组（A组，45例）和对照组（B组，45例）]，分别给予美乐托宁和长效硝苯地平治疗4周。观察各组患者治疗前后收缩压、舒张压和睡眠时间的变化。结果两组入选患者基线数据无统计学意义（P〉0．05）。A、B两组血压治疗后比治疗前显著下降[收缩压（mmHg）：A组（140．66±13．43）比（168．52±8．98），P〈0．01，B组（140．69±13．22）比（168．07±10．48），P〈0．01；舒张压（mmHg）：A组（91．26±7．71）比（109．75±7．07），P〈0．01，B组（92．14±12．05）比（108．41±8．34），P〈0．01]，但两组间比较差异无统计学意义（P〉0．05）。治疗后两组睡眠时间比治疗前均明显延长[A组（6．18±1．31）h比（4．43±0．42）h，19〈0．01，B组（4．83±0．70）h比（4．51±0．31）h，P=0．015]，但A组延长更加显著（P〈0．01）。A组无论是收缩压还是舒张压下降均与睡眠时间的延长相关（r=0．683，P〈0．01，r=0．612，P〈0．01），但B组仅舒张压的变化与睡眠时间的变化相关（r=0．303，P=0．045）。结论美乐托宁能显著降低睡眠剥夺相关性高血压患者的收缩压和舒张压。收缩压、舒张压的下降伴有睡眠时间的显著延长。

The effects of Melatonin on blood pressure in patients with sleep-deprivation-related hypertension

Objective To study the effects of Melatonin on blood pressures （BP） in patients with sleepdeprivation-related hypertension and whether the changes of blood pressure related to the improvement of sleep or not. Methods With paired comparison method, the selected patients were randomly divided into 2 groups and were treated by Melatonin [treatment group（group A, n=45 ）]or by long-acting nefidipine[ control group（group B, n=45 ） ] for 4 weeks. Systolic blood pressures （SBP）, diastolic blood pressures （DBP） and sleep were recorded before and after treatment. Results There were no differences between group A and group B in baseline data （P〉 0.05）. SBPs[ （168.52±8.98） vs （140.66±13.43）, P〈0.01, （168.07±10.48） vs （140.69±13.22）, P〈0.01 ], DBPs [ （109.75±7.07） vs （91.26±7.71）, P〈0.01, （108.41±8.34） vs （92.14±12.05）, P〈0.01 ] were markly reduced after treatment in group A and group B, but no differences after treatment between group A and group B [ （140.66± 13.43） vs （140.69±13.22）, P〉0.05, （91.26±7.71） vs （92.14±12.05）, P〉0.05）]. Sleep duration after treatment were significantly prolonged in two groups[（4.43±0.42） vs （6.18±1.31）, P〈0.01, （4.51±0.31） vs （4.83±0.70）, P=0.015） ], but more significant prolongation were seen in group A as comparing with group B [ （6.18±1.31） vs （4.83±0.70）, P〈0.01）]. The changes of SBP and DBP in group A were related to the prolongation of sleep duration （r=0.683, P〈0.01, r=0.612, P〈0.01）, but the changes of DBPs were only related to the prolongation of sleep duration in group B（r=0.303, P=0.045 ）. Conclusion Melatonin treatment for 4 weeks significantly reduces blood pressures in patients with sleep deprivation related hypertension. The declines of systolic and diastolic BP accompany with the prolongation of sleep duration.