两种联合用药方案治疗老老年高血压的疗效和安全性  

Effect and Safety of Two Kinds of Combination Therapy in the Treatment of Very Eldly Patients with Hypertension

作　　者：张良根 潘海英 

机构地区：[1]平湖市当湖街道社区卫生服务中心,浙江平湖314200 [2]平湖市第一人民医院

出　　处：《中外医学研究》2015年第34期25-27,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的：探讨小剂量氢氯噻嗪联合左旋氨氯地平或厄贝沙坦治疗80岁以上老老年高血压的疗效和安全性。方法：选择62例老老年高血压患者,按照随机数字表法分为左旋氨氯地平＋氢氯噻嗪组（A组）32例、厄贝沙坦＋氢氯噻嗪组（B组）30例,两组均予氢氯噻嗪6.25-12.5 mg,1次/d,A组＋左旋氨氯地平2.5-5 mg,1次/d,B组＋厄贝沙坦75~150 mg,1次/d,疗程均为12周,观察两组治疗2、4、8、12周后的血压变化和药物不良反应,疗程结束后对两组的疗效和安全性进行评价并比较。结果：随治疗周期的延长,两组SBP、DBP、PP均逐步降低,与治疗前比较差异均有统计学意义（P〈0.05）;治疗后SBP降幅两组比较差异均无统计学意义（P〉0.05）,DBP降幅B组更为明显（P〈0.05）,PP缩幅A组更为显著（P〈0.05）;两组总有效率相似（87.5%vs 83.3%,P〉0.05）,且不良反应发生率比较差异无统计学意义（31.3%vs 26.7%,P〉0.05）。结论：两种联合用药方案治疗老老年高血压均有较好疗效和安全性,左旋氨氯地平联合小剂量氢氯噻嗪对SBP降幅较大,对DBP降幅相对较小,故PP缩小明显,用于治疗单纯收缩压高的老老年患者更为合适;厄贝沙坦联合小剂量氢氯噻嗪对SBP、DBP降幅同样明显,PP缩小不明显,比较适合治疗收缩压和舒张压均高的老老年患者。Objective：To discuss the effect and safety of small dose Hydrochlorothiazide combined with Levamlodipine or Irbesartan in the treatment of hypertension in patients 80 years of age or older.Method：62 cases of very elderly patients with hypertension were randomized divided into Levamlodipine plus Hydrochlorothiazide group（group A,n=32） and Irbesartan plus Hydrochlorothiazide group（group B,n=30）.32 cases were treated daily dose of Levamlodipine 2.5-5 mg and Hydrochlorothiazide 6.25-12.5 mg,while 30 cases were treated by Irbesartan 75-150 mg plus Hydrochlorothiazide 6.25-12.5 mg once a day for 12 weeks.After treatment of 2,4,8 and 12 weeks,the changes of systolic blood pressure（SBP）,diastolic blood pressure（DBP） and pulse pressure（PP）, and the adverse drug reactions（ADR） of two groups were observed.12 weeks later,the effect and safety of two groups were evaluated and compared.Result：SBP,DBP and PP of two groups were gradually decreased as the extension of treatment course,there were significant differences compared with those of before treatment（P〈0.05）.By comparison,the degree of decreasing DBP in group B was obviously larger than that in group A,while the degree of decreasing PP in group A was obviously larger than that in group B,there were significant differences（P〈0.05）.However,the degree of decreasing SBP in two groups had no differences（P〈0.05）.The total effective rates of two groups were approximate（87.5% vs 83.3%,P〉0.05）,and ADR had no differences between two groups（31.3% vs 26.7%,P〉0.05）.Conclusion：Two kinds of therapeutic regimens all have good effect and safety in the treatment of very elderly patients with hypertension.Levamlodipine combined with small dose Hydrochlorothiazide for reducing the degree of SBP is larger,and reducing the degree of DBP is small,so PP is significantly decreased,it seems to be more suitable for treating isolated systolic hypertension in very elderly patients.While irbesartan combination with small dose hydrochlorothi

关 键 词：左旋氨氯地平 厄贝沙坦 氢氯噻嗪 老老年 高血压 疗效 安全性 

分 类 号：R544.1[医药卫生—心血管疾病]