联合药物治疗轻、中度原发性高血压降压效果和安全性的研究  

Effect and safety of combined medication for the treatment of mild to moderate essential hypertension

作　　者：王俊利[1] 周晓芳[2] 

机构地区：[1]长治医学院附属和济医院心内科,山西长治046011 [2]四川省人民医院干部医疗科,四川成都610072

出　　处：《实用医院临床杂志》2009年第1期40-42,共3页Practical Journal of Clinical Medicine

摘　　要：目的观察福辛普利联合小剂量氢氯噻嗪治疗轻、中度原发性高血压的降压效果和安全性。方法轻、中度原发性高血压患者32例,服用福辛普利10 mg,qd,联用氢氯噻嗪25 mg,qd。疗程16周。定期门诊随访监测血压、心率,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43%,71.5%,91.3%。在降低24小时平均收缩压(MSBP)、血压负荷以及24小时脉压(PP)方面均有明显效果,与治疗前相比差异有显著性意义(P<0.05)。降压较平缓,治疗后动态血压曲线更趋于"杓形"。谷峰比值(T/P)收缩压(SBP)和舒张压(DBP)分别为0.83和0.92,平滑指数(SI)SBP和DBP分别为3.01和2.97,治疗16周后,复查血液生化等指标与治疗前差异无显著性意义(P>0.05)。结论福辛普利联合小剂量氢氯噻嗪能持续平稳、有效及安全的降低24小时血压,且安全性良好。Objective To investigate the efficacy and safety of Fosinopril plus hydrochlorothiazide in patients with mild to moderate essential hypertension. Methods 32 patients with mild to moderate hypertension orally received Fosinopril 10 mg/d and hydrochlorothiazide 25 mg/d. The course of therapy was designed as long as 16-weeks. Statistical analysis was performed after a series of indices including ABPM, blood glucose, blood lipid and uric acid detected before and after treatment. Results A gradual decrease of blood pressure and heart rate was observed from 1 to 8 weeks. The effective rate was 43%, 71.5% , 91.3% at 2-week, 4-week, and 8-week course of therapy respectively. There was a significant decrease in the levels of 24h MSBP, blood pressure load and 24h PP compared with the same indices before treatment （ P 〈 0. 05）. A＂dipper＂ curve of ABPM was found after treatment. The T/P levels of SBP and DBP were 0. 83 and 0.92 respectively, while the SI levels of SBP and DBP were 3.01 and 2.97 respectively. No metabolic parameters changes were observed after treatment. Conclusion Fosinopril plus hydrochlorothiazide can decrease 24 h blood pressure smoothly and safely.

关 键 词：原发性高血压 联合治疗 动态血压监测 谷峰比值 平滑指数 脉压 血管紧张素转换酶抑制剂 

分 类 号：R541.3[医药卫生—心血管疾病]