2种单片复方制剂治疗老年原发性高血压的疗效对比  

Comparison of two single-pill combinations in the treatment of elderly hypertensive patients

作　　者：谢玉兰[1] 任利群[1] 邓钢[2] 孙晓美[3] 汤日宁[4] 邹继红[1] 李洁[1] 周波[1] 安丽[1] 郑婧[1] 慕广建[1] 

机构地区：[1]东南大学附属中大医院老年科,江苏南京210009 [2]东南大学附属中大医院放射科,江苏南京210009 [3]东南大学附属中大医院消化科,江苏南京210009 [4]东南大学附属中大医院肾内科,江苏南京210009

出　　处：《中华高血压杂志》2012年第12期1128-1133,共6页Chinese Journal of Hypertension

基　　金：江苏省自然科学基金资助项目(BK2010395;BK2011603);东南大学创新基金(seucx20110907)

摘　　要：目的观察单片复方制剂(SPC)厄贝沙坦150mg/氢氯噻嗪12.5mg与氨氯地平5mg/缬沙坦80mg治疗24周对老年原发性高血压患者的降压疗效及安全性。方法选择已使用单药治疗但血压未达标的老年(60～80岁)高血压患者196例,随机分成两组,A组98例换用厄贝沙坦150mg/氢氯噻嗪12.5mg,B组98例换用氨氯地平5mg/缬沙坦80mg,随访24周,记录血压、心率及不良反应;监测血生化指标;测定左心室质量指数(LVMI);测定颈动脉内膜中层厚度(IMT),计算斑块积分;进行尿蛋白检测。结果 181例完成了24周随访研究;两组收缩压、舒张压和脉压在用药后第4周开始明显下降[与入组时同组相比,A组收缩压(147.5±9.3)比(159.5±5.6)mmHg、舒张压(83.5±7.7)比(90.6±7.9)mmHg、脉压(62.5±7.6)比(68.3±7.2)mmHg;B组收缩压(145.8±10.1)比(158.7±6.3)mmHg、舒张压(83.7±8.8)比(91.3±6.5)mmHg、脉压(61.7±7.3)比(69.2±8.5)mmHg;均P<0.05],组间相比差异无统计学意义(P>0.05)。A组时期达标率为90.0%,B组时期达标率为91.2%;入组24周与入组时同组相比,两组LVMI、颈动脉IMT及斑块总积分、尿白蛋白与肌酐比值的差异均有统计学意义(P<0.05),组间相比差异无统计学意义(P>0.05);血生化指标组内及组间相比差异无统计学意义(P>0.05);但A组血钾有所下降,B组心率有所升高。结论 2种SPC在老年高血压患者中的应用有效、安全,都可以改善靶器官亚临床病变,各有其优势。Objective To compare the antihypertensive effects and safety of 2 single-pill combinations （irbesartan 150 mg/hydrochlorothiazide 12.5 mg and valsartan 80 mg/amlodipine 5 mg） in the elderly hypertensive patients. Methods One hundred and ninety-six elderly （60-80 years old） hypertensive patients who failed to reach the blood pressure target with one of the single antihypertensive drugs were randomized to two groups. Group A （98 pa- tients） received irbesartan 150 mg/hydrochlorothiazide 12.5 mg and group B （98 patients） were treated with valsar- tan 80 mg/amlodipine 5 mg. Patients were followed for 24 weeks. Systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate, pulse pressure and any side effects were documented during the time. Routine blood test, urinary protein, left ventricular mass index （LVMI）, left ventricular ejection fraction （LVEF）, carotid artery intima-media thickness （IMT）and plaque score were checked before and after the treatment. Results One hundred eighty-one patients completed the 24-week follow-up, both groups had a significant decrease in blood pressure after 4 weeks treatment compared with beginning [group A： SBP （147.5±9.3） vs （159.5±5.6）mm Hg, DBP （83.5± 7.7） vs （90.6±7.9）mm Hg, PP （62.5±7.6） vs （68.3±7.2）mm Hg; group B： SBP （145.8±10.1） vs {158.7± 6.3）mm Hg, DBP （83.7±8.8） vs （91.3±6.5）mm Hg, PP （61.7±7.3） vs （69.2±8. 5）mm Hg;P〈0.05]. No differences were found between the 2 groups（P〉0.05）. The control rate for blood pressure was 90. 0% in group A and 91.2% in group B （P〉0.05）. LVMI, IMT, total plaque score and urinary albumin/creatinine ratio weresignificantly decreased in the 2 groups compared with beginning after the treatment （ P〈0.05 ）. No differences were found between the 2 groups. Serum potassium were found decreased in the group A while heart rate were ele- vated in the group B. Conclusion Both the 2 single-pill combinations are effective, safe an

关 键 词：单片复方制剂 老年高血压 靶器官亚临床病变 

分 类 号：R544.1[医药卫生—心血管疾病]