厄贝沙坦氢氯噻嗪和富马酸比索洛尔联合治疗青年高血压  

Treated with irbesartan,hydrochlorothiazide and fumarate bisoprolol in young patients of hypertension

作　　者：李海霞[1] 赵志宏[1] 宋庆桥[1] 吴华芹[1] 刘金凤[1] 胡元会[1] 

机构地区：[1]中国中医科学院广安门医院心内科,北京100053

出　　处：《中华高血压杂志》2011年第4期324-328,共5页Chinese Journal of Hypertension

摘　　要：目的对比观察厄贝沙坦氢氯噻嗪与富马酸比索洛尔治疗青年原发性高血压的临床疗效。方法采用随机、平行对照的研究方法,选择青年原发性高血压患者240例,随机分为厄贝沙坦氢氯噻嗪组、富马酸比索洛尔组和联合用药组,每组分别用药4周。观察治疗前后诊室血压、动态血压、心率、心脏结构和功能的变化。结果从治疗第2周开始3组血压均有所下降,在治疗4周末下降最明显;其中厄贝沙坦氢氯噻嗪组收缩压降低较为明显,富马酸比索洛尔组舒张压降低较为明显,联合用药组收缩压和舒张压降低均较显著(均P<0.05);联合用药组与其他两组比较血压明显降低(P<0.05)。富马酸比索洛尔组和联合用药组心率均在正常范围内降低,厄贝沙坦氢氯噻嗪组心率下降不明显。在心脏结构方面,联合用药组左心室舒张末内径(LVIDd)和左心室质量指数(LVMI)较治疗前减小,厄贝沙坦氢氯噻嗪组LVMI也较治疗前减少。在心脏功能方面,联合用药组A峰降低、E峰升高(均P<0.05)。治疗前后24h平均收缩压压差和白昼平均收缩压压差与LVMI轻度相关(分别为r=0.203,P=0.025和r=0.189,P=0.034)。结论厄贝沙坦氢氯噻嗪和富马酸比索洛尔治疗青年高血压患者均具有良好的降血压作用,两者联合有协同效应。Objective To evaluate the effectiveness of irbesartan/hydrochlorothiazide（Irbesartan/HCTZ）and fumarate bisoprolol in young patients of hypertension.Methods Two hundred forty young patients of hypertension were enrolled and randomized into three groups：Irbesartan/HCTZ group,fumarate bisoprolol group and combination group on the principle of double-blind and parallel control.Office blood pressure,heart rate,twenty-four hour ambulatory blood pressure monitor（ABPM）,cardiac structure and function were determined before and after 4 weeks treatment respectively.Results The blood pressure began to decrease 1 week later and showed a significant decrease at the end of the treatment in three groups.Systolic blood pressure（SBP）was significantly decreased in Irbesartan/HCTZ group,diastolic blood pressure（DBP）was significantly decreased in fumarate bisoprolol group,while SBP and DBP were effectively decreased in combination group（P〈0.05）,and the blood pressure was lower in combination group than in the other two groups（P〈0.05）.Heart rate decreased within normal limits in fumarate bisoprolol group and combination group,but the change was not significant in Irbesartan/HCTZ group.Left ventricular internal diameter end-diastolic（LVIDd）was markedly decreased in combination group,left ventricular mass index（LVMI）was decreased in Irbesartan/HCTZ group and combination group.Significant difference was found in peak A and peak E in combination group（P〈0.05）.Differential pressure of 24 h average systolic pressure and daytime average systolic pressure was slightly correlated to the decrease of LVMI respectively（r=0.203,P=0.025 and r=0.189,P=0.034）.Conclusions Irbesartan/HCTZ and fumarate bisoprolol have a similar potent anti-hypertension effect,and the combination therapy have synergistic effect in young patients of hypertension.

关 键 词：厄贝沙坦氢氯噻嗪 富马酸比索洛尔 青年 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]