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目的:用无创性动态血压监测仪评价国产复方坎地沙坦酯片(坎地沙坦酯16 mg/氢氯噻嗪12.5 mg)对原发性高血压患者的降压疗效。方法:原发性高血压患者经过2周清洗期后,进入坎地沙坦酯片8 mg 单药治疗期,对4周后坐位血压未达标者(达标为血压<140/90 mmHg),进行24小时动态血压监测,以随机双盲、平行对照试验方法,分别服用复方坎地沙坦酯片(复方坎地沙坦酯组,28例)或16 mg 坎地沙坦酯片(坎地沙坦酯组,27例)治疗8周。比较两组服药前后24小时动态血压参数变化。观察组内与组间服药前后的不同时段的血压变化,谷峰比值及血压平滑指数。结果:共55例患者完成动态血压监测,两组基础指标比较无差异。复方坎地沙坦酯组与坎地沙坦酯组药后收缩压/舒张压/平均动脉压全日平均值(24小时)、日间平均值(6:00～22:00)、夜间平均值(22:00～6:00)均明显下降,与同组基线值比较均有极显著性差异(P<0.01)。组间比较,复方坎地沙坦酯组收缩压/舒张压/平均动脉压全日平均值(24小时)、日间平均值(6:00～22:00)、夜间平均值(22:00～6:00)的降低幅度与坎地沙坦酯组比较均有极显著性差异(P<0.01)。服药谷峰比值(SBP/DBP)复方坎地沙坦酯组分别为99.36%(19.16/19.28 mmHg)和87.36%(10.14/11.61 mmHg),复方坎地沙坦酯组分别为54.42%(7.30/13.41 mmHg)和64.86%(6.43/9.91 mmHg)。血压平滑指数(SBP/DBP)在复方坎地沙坦酯组为4.53/3.91,坎地沙坦酯组为1.29/1.52。结论:复方坎地沙坦酯片对原发性高血压患者有较好的降压作用,复方制剂比单药降压幅度大、持续时间长。动态血压平均下降幅度日间>全天>夜间,收缩压>舒张压。复方坎地沙坦酯控制血压更平稳。
Objective: To evaluate the antihypertensive effects of candesartan cilexetil (candesartan cilexetil 16 mg / hydrochlorothiazide 12.5 mg) in patients with essential hypertension by noninvasive ambulatory blood pressure monitor. Methods: Patients with essential hypertension entered candesartan cilexetil 8 mg monotherapy period after 2 weeks of cleansing period. After 4 weeks of sitting, blood pressure was not reached (blood pressure <140/90 mmHg) 24-hour ambulatory blood pressure monitoring, randomized double-blind, parallel controlled trials, were given compound candesartan cilexetil tablets (candesartan cilexetil group, 28 cases) or 16 mg candesartan cilexetil tablets Tantalum group, 27 cases) for 8 weeks. The changes of ambulatory blood pressure parameters before and after treatment were compared between the two groups. The change of blood pressure, the peak-to-peak ratio and the index of blood pressure smoothness were observed before and after treatment in the group. Results: A total of 55 patients completed ambulatory blood pressure monitoring. There was no difference between the two groups in basic indexes. The mean systolic blood pressure / diastolic blood pressure / mean arterial pressure (24 hours), the average of the daytime (6: 00-22: 00), the nighttime mean of the candesartan cilexetil (22: 00 ~ 6: 00) decreased significantly compared with the baseline values of the same group (P <0.01). The mean systolic blood pressure / diastolic blood pressure / mean arterial blood pressure (24 hours) in the candesartan cilexetil group, the average daily time (6: 00-22: 00), nighttime average 6:00) decreased significantly compared with the candesartan cilexetil group (P <0.01). The candesartan ciprofloxacin (99.36% (19.16 / 19.28) mmHg and 87.36% (10.14 / 11.61 mmHg), respectively) in the compound candesartan cilexetil group were 54.42% (7.30 / 13.41 mmHg) and 64.86% (6.43 / 9.91 mmHg). The blood pressure smoothing index (SBP / DBP) was 4.53 / 3.91 in the candesartan cilexetil group and 1.29 / 1.52 in the candesartan cilexetil group. Conclusion: The compound candesartan cilexetil tablet has a good antihypertensive effect on patients with essential hypertension. The compound prescription has a longer duration and longer duration of antihypertensive effect than single drug. The average decline in ambulatory blood pressure during the day> all day> night, systolic blood pressure> diastolic blood pressure. Compound candesartan cilexetil controls blood pressure more smoothly.