吲达帕胺、氯沙坦钾氢氯噻嗪片分别联合硝苯地平控释片治疗老年顽固性单纯收缩期高血压患者的效果及对肾功能指标影响的对照分析
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摘要
目的观察吲达帕胺、氯沙坦钾氢氯噻嗪片分别联合硝苯地平控释片治疗老年顽固性单纯收缩期高血压患者的效果及对肾功能指标的影响。方法选取老年顽固性单纯收缩期高血压患者100例,按照随机数表法分为研究组和对照组,研究组给予氯沙坦钾氢氯噻嗪片联合硝苯地平控释片治疗,对照组给予吲达帕胺联合硝苯地平控释片治疗。观察对比2组治疗前后随测血压、24h动态血压及心率、肾功能指标,以及2组的临床疗效。结果2组治疗前及治疗后1,2,4个月随测血压在组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05);治疗后,研究组24h平均收缩压(24-hour mean systolic blood pressure,24hSBP)、24h平均舒张压(24-hour mean diastolic blood pressure,24hDBP)、白昼平均收缩压(daytime mean systolic blood pressure,dSBP)、夜间平均收缩压(nighttime mean systolic blood pressure,nSBP)明显优于对照组(P<0.05),而2组舒张压与心率差异均无统计学意义(P>0.05);治疗后,研究组肾功能指标明显优于对照组(P<0.05),2组总有效率差异有统计学意义(P<0.05)。结论氯沙坦钾氢氯噻嗪片联合硝苯地平控释片治疗老年顽固性单纯收缩期高血压效果较吲达帕胺联合硝苯地平控释片方案明显,患者的肾功能改善明显。
Objective To compare the effects and renal function of indapamide and losartan potassium hydrochlorothiazide tablets combined with nifedipine on the treatment of refractory simple systolic hypertension in elderly patients.Methods A total of 100 patients with refractory simple systolic hypertension were enrolled.They were divided into study group and control group according to the random number table.The study group were given losartan potassium hydrochlorothiazide tablets combined with nifedipine controlled release tablets,the control group were given indapamide combined with nifedipine controlled release tablets treatment.The blood pressure,24 hambulatory blood pressure and heart rate,renal function,and the clinical efficacy of the two groups of patients were measured and observed before and after treatment.ResultsThere were significant differences in the blood pressure between two groups,time points and two-way interaction at 1,2 and 4 months after treatment(P<0.05).After treatment,the 24-hour mean systolic blood pressure(24 hSBP),24-hour mean diastolic blood pressure(24 hdSBP),daytime mean systolic blood pressure(dSBP),nighttime mean systolic blood pressure(nSBP)of the study group were significantly higher than those in the control group(P<0.05).There was not significant difference in diastolic blood pressure and heart rate between two groups(P>0.05).After treatment,the patients in the study group were significantly higher than those in the control group(P<0.05).Conclusion Losartan potassium hydrochlorothiazide tablets combined with nifedipine controlled release tablets to improve the elderly patients with intractable systolic hypertension than indapamide combined with nifedipine sustained-release tablets program is effective,the patients′renal function are improved significantly.
Objective To compare the effects and renal function of indapamide and losartan potassium hydrochlorothiazide tablets combined with nifedipine on the treatment of refractory simple systolic hypertension in elderly patients.Methods A total of 100 patients with refractory simple systolic hypertension were enrolled.They were divided into study group and control group according to the random number table.The study group were given losartan potassium hydrochlorothiazide tablets combined with nifedipine controlled release tablets,the control group were given indapamide combined with nifedipine controlled release tablets treatment.The blood pressure,24 hambulatory blood pressure and heart rate,renal function,and the clinical efficacy of the two groups of patients were measured and observed before and after treatment.ResultsThere were significant differences in the blood pressure between two groups,time points and two-way interaction at 1,2 and 4 months after treatment(P<0.05).After treatment,the 24-hour mean systolic blood pressure(24 hSBP),24-hour mean diastolic blood pressure(24 hdSBP),daytime mean systolic blood pressure(dSBP),nighttime mean systolic blood pressure(nSBP)of the study group were significantly higher than those in the control group(P<0.05).There was not significant difference in diastolic blood pressure and heart rate between two groups(P>0.05).After treatment,the patients in the study group were significantly higher than those in the control group(P<0.05).Conclusion Losartan potassium hydrochlorothiazide tablets combined with nifedipine controlled release tablets to improve the elderly patients with intractable systolic hypertension than indapamide combined with nifedipine sustained-release tablets program is effective,the patients′renal function are improved significantly.
引文
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[2]任思军,何颖群,李丹,等.两种方案对老年收缩期高血压疗效比较[J].中国实用医药,2012,7(10):63-65.
[3]中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[J].中国实用乡村医生杂志,2012,19(10):1-12.
[4]王小凤,王瑞英,杨建国,等.血清脂联素、内脂素水平与高血压伴肥胖患者胰岛素抵抗的关系[J].河北医科大学学报,2013,34(12):1588-1591.
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[7]曲慧馨,张梅.培哚普利吲达帕胺复方制剂对老年单纯收缩期高血压患者的降压疗效探讨[J].重庆医学,2014,43(25):3359-3361.
[8]张毅,李路涛,将若瑜,等.硝苯地平联合吲达帕胺对老年顽固性单纯收缩期高血压的临床观察[J].牡丹江医学院学报,2014,35(2):62-63.
[9]王琪.心脑舒通胶囊联合硝苯地平控释片治疗老年单纯收缩期高血压84例[J].中西医结合心脑血管病杂志,2012,10(1):103-104.
[10]张生潭,兰新宇,杨达宇,等.国产与进口降压药物治疗高血压患者临床疗效的荟萃分析[J].河北医科大学学报,2015,36(6):632-637.
[11]谢玉霞,武刚.吲达帕胺联合氨氯地平治疗高血压合并冠心病患者的疗效观察[J].重庆医学,2013,42(6):640-641,644.
[12]符弟,王秋雁.吲达帕胺联合缬沙坦对高血压合并糖尿病患者血压及尿微量白蛋白的影响[J].中国老年学杂志,2013,33(20):4963-4964.
[13] Kobayashi N,Ishimitsu T.Assessment on antihypertensive effect and safety of nifedipine controlled-release tablet administered at 80 mg/day in practical clinic[J].Clini Exp Hypertens,2012,34(3):191-200.
[14]钟茂辉,齐林.氯沙坦钾氢氯噻嗪治疗老年性高血压疗效观察[J].中国当代医药,2012,19(23):76-78.
[15] Roos C,Spaanderman ME,Schuit E,et al.Effect of maintenance tocolysis with nifedipine in threatened preterm labor on perinatal outcomes:a randomized controlled trial[J].Jama,2013,309(1):41-47.
[16]袁锋,管春静.氯沙坦氢氯噻嗪合剂治疗血管紧张素Ⅱ受体拮抗剂控制无效的高血压患者疗效研究[J].河北医学,2014,20(2):210-213.
[17]方立本,周翠玲,赵珺,等.硝苯地平控释片联合氯沙坦钾氢氯噻嗪治疗老年顽固性单纯收缩期高血压临床疗效及安全性[J].中国循证心血管医学杂志,2016,8(3):328-330.
[2]任思军,何颖群,李丹,等.两种方案对老年收缩期高血压疗效比较[J].中国实用医药,2012,7(10):63-65.
[3]中国高血压防治指南修订委员会.中国高血压防治指南(2010年修订版)[J].中国实用乡村医生杂志,2012,19(10):1-12.
[4]王小凤,王瑞英,杨建国,等.血清脂联素、内脂素水平与高血压伴肥胖患者胰岛素抵抗的关系[J].河北医科大学学报,2013,34(12):1588-1591.
[5]邹文淑,王剑峰,周莉华,等.老年单纯收缩期高血压的诊治进展[J].中华老年心脑血管病杂志,2014,16(12):1343-1344.
[6]张燕梅.老年单纯收缩期高血压及其防治[J].解放军预防医学杂志,2012,30(5):384-386.
[7]曲慧馨,张梅.培哚普利吲达帕胺复方制剂对老年单纯收缩期高血压患者的降压疗效探讨[J].重庆医学,2014,43(25):3359-3361.
[8]张毅,李路涛,将若瑜,等.硝苯地平联合吲达帕胺对老年顽固性单纯收缩期高血压的临床观察[J].牡丹江医学院学报,2014,35(2):62-63.
[9]王琪.心脑舒通胶囊联合硝苯地平控释片治疗老年单纯收缩期高血压84例[J].中西医结合心脑血管病杂志,2012,10(1):103-104.
[10]张生潭,兰新宇,杨达宇,等.国产与进口降压药物治疗高血压患者临床疗效的荟萃分析[J].河北医科大学学报,2015,36(6):632-637.
[11]谢玉霞,武刚.吲达帕胺联合氨氯地平治疗高血压合并冠心病患者的疗效观察[J].重庆医学,2013,42(6):640-641,644.
[12]符弟,王秋雁.吲达帕胺联合缬沙坦对高血压合并糖尿病患者血压及尿微量白蛋白的影响[J].中国老年学杂志,2013,33(20):4963-4964.
[13] Kobayashi N,Ishimitsu T.Assessment on antihypertensive effect and safety of nifedipine controlled-release tablet administered at 80 mg/day in practical clinic[J].Clini Exp Hypertens,2012,34(3):191-200.
[14]钟茂辉,齐林.氯沙坦钾氢氯噻嗪治疗老年性高血压疗效观察[J].中国当代医药,2012,19(23):76-78.
[15] Roos C,Spaanderman ME,Schuit E,et al.Effect of maintenance tocolysis with nifedipine in threatened preterm labor on perinatal outcomes:a randomized controlled trial[J].Jama,2013,309(1):41-47.
[16]袁锋,管春静.氯沙坦氢氯噻嗪合剂治疗血管紧张素Ⅱ受体拮抗剂控制无效的高血压患者疗效研究[J].河北医学,2014,20(2):210-213.
[17]方立本,周翠玲,赵珺,等.硝苯地平控释片联合氯沙坦钾氢氯噻嗪治疗老年顽固性单纯收缩期高血压临床疗效及安全性[J].中国循证心血管医学杂志,2016,8(3):328-330.