非洛地平缓释片联合氢氯噻嗪治疗老年高血压降压效果和安全性的研究  

Study of clinical effect and safety of combined therapy of felodipine sustained release tablet and hydrochlorothiazide on the elderly hypertension

作　　者：王俊利[1] 周晓芳[2] 

机构地区：[1]山西省长治医学院附属和济医院心内科,山西长治046011 [2]四川省医学科学院.四川省人民医院干部保健科,四川成都610072

出　　处：《实用医院临床杂志》2010年第4期73-76,共4页Practical Journal of Clinical Medicine

摘　　要：目的评价钙离子通道阻断剂(Ca2+channel block,CCB)非洛地平缓释片联合小剂量利尿剂氢氯噻嗪治疗老年轻、中度原发性高血压的降压疗效及安全性。方法选择门诊新诊断的老年轻、中度原发性高血压患者100例,服用非洛地平缓释片5 mg,qd,联用氢氯噻嗪25 mg,qd,治疗4周无效则加量,再治疗4周如无效则换药。疗程为16周,定期门诊随访监测血压、心率,并监测治疗前后血脂、血糖、电解质、肝肾功能等变化。结果门诊随访2、4、8周的有效率分别为48.5%、66.5%、84.6%,在降低24小时MSBP和MDBP,白天MSBP和MDBP,夜间MSBP和MDBP,血压负荷以及24小时脉压方面均有显著效果,与治疗前相比P<0.05;谷峰比值(T/P)收缩压和舒张压分别为0.67和0.86;平滑指数(SI)收缩压和舒张压分别为2.96和3.00;治疗16周后,复查血液生化等指标与治疗前无显著差异。结论非洛地平缓释片联合小剂量氢氯噻嗪不但能有效降低老年高血压患者门诊血压,而且能改善动态血压参数,而且降压安全,可作为老年高血压治疗的优选方案。Objective To search more effective therapy for mild to moderate hypertension of elderly.Methods 100 patients with elderly mild to moderate hypertension orally received Felodipine sustained release 5mg/d and hydrochlorothiazide 25mg/d.The course of therapy was designed as long as 16-weeks.During which,therapy planning would be changed as a result of no effect after 4-week's treatment.Statistical analysis was performed under the help of SPSS 11.5 software after a series of indices including ABPM,blood glucose,blood lipid and uric acid detected before and after treatment.X2 test were performed.Results Patients showed effect rate of 48.5%,66.5%,84.6%.The result showed significant decrease in the levels of 24h MSBP and MDBP,daytime or night MSBP and MDBP,blood pressure load and 24h PP compared with the same indices before treatment(P < 0.05).The T/P levels of SBP and DBP were 0.67 and 0.86;The SI levels of SBP and DBP were 2.96 and 3.00.No metabolic parameters changes were observed after treatment.Conclusion Felodipine sustained release adding hydrochlorothiazide can not only decrease clinic blood pressure but also ABPM,and could decrease blood pressure safely.Combination of Felodipine and hydrochlorothiazide may be served as a preferred therapeutic scheme for the elderly mild to moderate hypertension.

关 键 词：老年高血压 联合治疗 动态血压监测 谷峰比值 平滑指数 脉压 

分 类 号：R4[医药卫生—临床医学]