苯磺酸左旋氨氯地平治疗老年单纯收缩期高血压的临床观察

目的利用动态血压监测观察老年单纯收缩期高血压（ISH）患者在不同时间服左旋氨氯地平降压治疗疗效，探讨其临床意义。方法选未服用降压药物或停用其他降压药物治疗7天以上的86例老年单纯收缩期高血压（ISH）患者，随机分为早上服药组（n=42例）和晚上服药组（n=44例），口服苯磺酸左旋氨氯地平2．5mg／d，每日观察诊室血压。所有患者药物治疗前后行动态血压监测，共治疗12周。结果经左旋氨氯地平治疗后2组患者诊室血压明显降低（P〈O．05），且下降程度相近，无统计学意义（P〉0．05）。动态血压显示2组治疗后均能降低24h血压，降压程度相近，无统计学意义（P〉0．05）。早上服药组白天血压达标（SBP〈135mmHg）者占46．2％，夜间血压达标（SBP〈125mmHg）者占31．7％。晚上服药组白天血压这标（SBP〈135mmHg）者占42．5％，夜间血压达标（SBP〈125mmHg）者占51．3％。结论左旋氨氯地平对老年单纯收缩期高血压（ISH）患者有较好的降压效果，特别是对夜间血压升高非杓型高血压患者在晚上服药可以提高夜间血压达标率，更好纠正血压昼夜节律异常，以减少高血压患者心、脑、肾等靶器官损害。

Effect of levoamlodipine besylate on isolated systolic hypertension

Objective To observe the antihypertensive effect of levoamlodipine besylate on isolated systolic hypertension patients. Methods 86 patients, not taking antihypertensive drugs or discarding other antihypertensive drugs therapy for more than 7 days, were randomly divided in to the morning medication group （n=42） and the evening medication group （n =44）, and taken levoamlodipine besylate （2.5 mg · d） for 12 weeks. The blood pressure was observed with ambulatory blood pressure monitoring before and after treatment. Results The blood pressure of the two groups significantly decreased （P 〈0. 05）, and the degree of temporary blood pressure decline was similar （P 〉0. 05）. Ambulatory blood pressure monitoring show that blood pressure of both of two groups decrease, and the antihypertensive degree was similar （P〉0. 0 5）. Among the morning medication group, the rate of daytime blood pressure target hitting （SBP〈135mmHg） was 46.2%, and nightime blood pressure target hitting （SBP〈125mmHg） was 31.7%. Among the evening medication group, the rate of daytime blood pressure target hitting （SBP〈135mmHg） was 42.5%, and nightime blood pressure target hitting （SBP〈125mmHg） was 51.3%. Conclusion Levoamlo dipine besylate has a satisfactory antihypertensive effect for isolated systolic hypertension, especially for non-dipper hypertension patients with high blood pressure at night.