摘要
目的探讨培哚普利联合氢氯噻嗪或氨氯地平治疗老年高血压的疗效。方法选取西城区广外社区卫生服务中心2014年1月-2016年9月收治的120例高血压老年患者,按随机数字表法分为研究组和对照组,2组患者均给予培哚普利治疗,对照组患者加用氢氯噻嗪,研究组患者加用氨氯地平,疗程均为8周,比较2组治疗前后血压、血钾(K)、血尿酸(UA)及血清胱抑素(cystatin C,Cys-C)改善情况,不良反应发生情况。结果研究组血压达标率高于对照组(93.33%vs 80.00%),差异有统计学意义(χ^2=4.615,P<0.05)。治疗后2组患者24h平均收缩压(systolic blood pressure,SBP),白昼平均SBP(dSBP),夜间平均SBP(nSBP)均较治疗前改善,其中研究组SBP昼夜节律较对照组高,差异有统计学意义(P<0.05)。治疗后2组患者24 h平均舒张压(diastolic blood pressure,DBP),白昼平均DBP(dDBP),夜间平均DBP(nDBP)均较治疗前改善,其中研究组nDBP较对照组低,DBP昼夜节律较对照组高,差异有统计学意义(P<0.05)。治疗后研究组患者Cys-C较对照组低,且差异有统计学意义(P<0.05)。治疗后血K及UA水平组间比较差异无统计学意义(P>0.05)。研究组共发生3例(5.00%)不良反应,对照组共发生5例(8.33%)不良反应,不良反应发生率比较差异无统计学意义(χ^2=0.536,P>0.05)。结论在培哚普利基础上联合氢氯噻嗪及氨氯地平均可有效改善高血压老年患者血压状况,且安全性良好,但培哚普利联合氨氯地平在改善血压昼夜节律方面作用更强,血清胱抑素改变可能提示在肾脏保护方面具有一定的效果。
Objective To investigate the efficacy of perindopril combined with hydrochlorothiazide oramlodipine in the treatment of senile hypertension. Methods One hundred and twenty cases of elderly patients with hypertension treated between January 2014 and September2016 were chosen as the subjects and divided into the control group and research group.Both groups were treated with perindopril, but the control group additionally took hydrochlorothiazide while the research group was given amlodipine.The treatment lasted 8 weeks. The improvement of blood pressure, K, UA, Cys-C before and aftertreatment, and adverse reactions were compared between the two groups. Results The blood pressure compliance rate of the research group was higherthan that of the control group(93.33% vs 80.00%), and the difference was statistically significant(χ^2= 4.615, P<0.05). Aftertreat ment, the 24 h SBP, dSBP, nSBP and SBP blood pressure circadian rhythms of the two groups were all improved,and the SBP blood pressure circadian rhythm of the research group was betterthan that of control group,and the difference was statistically different(P<0.05).Aftertreatment, the 24 h DBP, dDBP, nDBP, DBP blood pressure circadian rhythms of the two groups were all improved, and the DBP blood pressure circadian rhythm of the research group was betterthan that of the control group, but nDBP was lower. The difference was statistically different(P<0.05). Cys-C of the research group aftertreatment was lowerthan that of the control group,and the difference was statistically different(P<0.05). There was no significant difference in blood K and UA levels between the two groups aftertreatment(P>0.05). There were 3 cases(5%)of adverse reactions in the research group, compared with 5 cases(8.33%)in the control group,and the difference was statistically significant(χ^2= 0.536, P<0.05). Conclusion Hydrochlorothiazide and amlodipine combined with perindopril could effectively and safely improve the blood pressure of elderly patients with hy pertension. However, perindopri
作者
张海川
ZHANG Haichuan(Guangwai Community Health Service Center,Xicheng District,Beijing 100055,China)
出处
《空军医学杂志》
2020年第1期75-78,共4页
Medical Journal of Air Force
关键词
高血压
氨氯地平
氢氯噻嗪
培哚普利
安全性
hypertension
amlodipine
hydrochlorothiazide
perindopril
security
