不同剂量螺内酯治疗难治性高血压的效果及对血压和脂代谢的影响
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摘要
目的观察不同剂量螺内酯治疗难治性高血压的效果及对血压和脂代谢的影响。方法选择本院2016年5月至2018年5月收治的92例难治性高血压患者,以随机化原则分为对照组(n=46,40 mg/d螺内酯)和研究组(n=46,20 mg/d螺内酯)。比较两组的临床疗效、血压、血脂、生活质量及不良反应。结果研究组的治疗总有效率、治疗后3个月的各项生活质量评分均高于对照组,差异具有统计学意义(P<0.05);治疗后,两组患者的SBP、DBP、LDL-C、TC、TG水平均降低,HDL-C水平均升高,且研究组优于对照组,差异具有统计学意义(P<0.05);研究组和对照组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论以小剂量螺内酯(20 mg/d)治疗难治性高血压,可有效降低血压,调节脂代谢,提升患者的生活质量,安全性高,值得临床推广应用。
Objective To observe the effect of different doses of spironolactone on refractory hypertension and its impact on blood pressure and lipid metabolism. Methods From May 2016 to May 2018, 92 patients with refractory hypertension admitted in our hospital were randomly divided into control group(46 cases, 40 mg/d spironolactone) and study group(46 cases,20 mg/d spironolactone). The clinical efficacy, blood pressure, blood lipid, quality of life and adverse reactions were compared between the two groups. Results The total effective rate of treatment and quality of life scores at 3 months after treatment in the study group were higher than those in the control group, and the differences were statistically significant(P <0.05). After treatment, the levels of SBP, DBP, LDL-C, TC and TG in both groups decreased, while the levels of HDL-C increased, those of the study group were better than the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the total incidence of adverse reactions between the study group and the control group(P >0.05).Conclusion Low-dose spironolactone(20 mg/d) can effectively reduce blood pressure, regulate lipid metabolism and improve the quality of life of patients with refractory hypertension. It is safe and worthy of clinical application.
Objective To observe the effect of different doses of spironolactone on refractory hypertension and its impact on blood pressure and lipid metabolism. Methods From May 2016 to May 2018, 92 patients with refractory hypertension admitted in our hospital were randomly divided into control group(46 cases, 40 mg/d spironolactone) and study group(46 cases,20 mg/d spironolactone). The clinical efficacy, blood pressure, blood lipid, quality of life and adverse reactions were compared between the two groups. Results The total effective rate of treatment and quality of life scores at 3 months after treatment in the study group were higher than those in the control group, and the differences were statistically significant(P <0.05). After treatment, the levels of SBP, DBP, LDL-C, TC and TG in both groups decreased, while the levels of HDL-C increased, those of the study group were better than the control group, and the differences were statistically significant(P<0.05). There was no significant difference in the total incidence of adverse reactions between the study group and the control group(P >0.05).Conclusion Low-dose spironolactone(20 mg/d) can effectively reduce blood pressure, regulate lipid metabolism and improve the quality of life of patients with refractory hypertension. It is safe and worthy of clinical application.
引文
[1]盖延红,栾晓东,朱为勇,等.螺内酯治疗不同年龄难治性高血压的疗效差别[J].中国循证心血管医学杂志,2015,7(4):537-538.
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[9]卢旭,余蕾蕾,陈光辉.小剂量螺内酯在老年难治性高血压患者中的疗效及安全性分析[J].河北医学,2017,23(8):1294-1301.
[10]郑静,万翔,朱冬梅,等.螺内酯对难治性高血压患者RAAS指标的影响研究[J].解放军医药杂志,2016,28(11):102-105.
[11]李彦影,葛欣.螺内酯联合卡维地洛治疗难治性高血压的临床分析[J].中国医药指南,2017,15(31):183-184.
[12] AZIZI M,SAPOVAL M,GOSSE P,et al.Optimum and stepped care standardised antihypertensive treatment with or without renal denervation for resistant hypertension(DENERHTN):a multicentre,open-label, randomised controlled trial[J].Lancet,2015,385(9981):1957-1965.
[13]杜灵枝.螺内酯联合常规抗高血压药物在难治性高血压治疗中的临床应用价值[J].中国实用医药,2015,10(23):165-166.
[14]余志国,鲍玉洁,丘军,等.卡维地洛联合螺内酯治疗高血压临床效果分析[J].中国实用医药,2016,11(18):41-42.
[2]李可.螺内酯联合卡维地洛治疗难治性高血压的效果观察[J].中国医药指南,2016,14(2):44-45.
[3]孙宁玲.《难治性高血压诊断治疗中国专家共识》要点及解读[J].中国循环杂志,2014,29(4):241-243.
[4]刘立立,张伶俐,曾力楠,等.卡维地洛联合螺内酯治疗难治性高血压的系统评价[J].医药导报,2015,34(s1):141-144.
[5]王新华,林美萍,许琳.不同剂量螺内酯对难治性高血压患者的疗效及糖脂代谢的影响[J].山东医药,2016,56(45):86-88.
[6]徐金霞,刘如品,王可.螺内酯联合常规抗高血压药物治疗难治性高血压的疗效分析[J].中国处方药,2016,14(5):78-79.
[7]吴彦虎.螺内酯联合常规抗高血压药物治疗难治性高血压的效果分析[J].基层医学论坛,2016,20(27):3787-3788.
[8]梅维德.螺内酯与特拉唑嗪治疗难治性高血压的疗效比较[J].临床合理用药杂志,2016,9(25):69-70.
[9]卢旭,余蕾蕾,陈光辉.小剂量螺内酯在老年难治性高血压患者中的疗效及安全性分析[J].河北医学,2017,23(8):1294-1301.
[10]郑静,万翔,朱冬梅,等.螺内酯对难治性高血压患者RAAS指标的影响研究[J].解放军医药杂志,2016,28(11):102-105.
[11]李彦影,葛欣.螺内酯联合卡维地洛治疗难治性高血压的临床分析[J].中国医药指南,2017,15(31):183-184.
[12] AZIZI M,SAPOVAL M,GOSSE P,et al.Optimum and stepped care standardised antihypertensive treatment with or without renal denervation for resistant hypertension(DENERHTN):a multicentre,open-label, randomised controlled trial[J].Lancet,2015,385(9981):1957-1965.
[13]杜灵枝.螺内酯联合常规抗高血压药物在难治性高血压治疗中的临床应用价值[J].中国实用医药,2015,10(23):165-166.
[14]余志国,鲍玉洁,丘军,等.卡维地洛联合螺内酯治疗高血压临床效果分析[J].中国实用医药,2016,11(18):41-42.