不同联合用药对老年单纯收缩期高血压患者大动脉僵硬度的疗效比较  

Effect of different combined drugs on conducting artery stiffness in elderly simple systolic hypertensive patients

作　　者：张万义[1] 宋安洋[1] 周明龙[1] 

机构地区：[1]中国石化集团胜利石油管理局胜利医院老年病科,东营257055

出　　处：《中华老年心脑血管病杂志》2016年第8期829-832,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨基于利尿剂、钙拮抗剂的不同联合用药对老年单纯收缩期高血压(ISH)患者血压、靶器官损害和大动脉僵硬度的影响。方法将最终完成试验的ISH患者95例分为4组,A组24例(吲达帕胺+苯磺酸氨氯地平);B组24例(吲达帕胺+苯磺酸氨氯地平+阿托伐他汀钙);C组23例(吲达帕胺+苯磺酸氨氯地平+马来酸依那普利);D组24例(吲达帕胺+苯磺酸氨氯地平+螺内酯);以24h动态血压判定降压疗效;以肱踝脉搏波传导速度(baPWV)作为动脉硬化指标;以室间隔、左心室后壁厚度及左心室质量作为靶器官损害指标。结果 4组治疗后较治疗前24h收缩压、舒张压、脉压均明显降低(P<0.01);baPWV明显减慢(P<0.01);C组较A、B和D组baPWV和舒张末左心室后壁厚度[(9.7±4.4)mmvs(10.5±4.0)mm、(10.7±4.5)mm和(10.3±4.7)mm,P=0.006]改变明显。结论老年ISH的治疗不仅要降低血压,而且应减少大动脉僵硬度。Objective To study the effect of different combined drugs on blood pressure,target organ damage and conducting artery stiffness in elderly simple systolic hypertensive patients.Methods Ninety-five simple systolic hypertensive patients were randomly divided into group A（n=24）,group B（n=24）,group C（n=23）,and group D（n=24）.The patients in group A were treated with indapamide＋benzene sulfonic acid amlodipine,those in group B were treated with indapamide＋benzene sulfonic acid amlodipine＋atorvastatin calcium,those in group C were treated with indapamide＋benzene sulfonic acid amlodipine maleate＋enalaprilat,and those in group D were treated with indapamide＋benzene sulfonic acid amlodipine＋spironolactone.The antihypertensive effect was determined according to the 24 hambulatory blood pressure（SBP,DBP,and PP）.The baPWV was used as the indicator of arterosclerosis.The interventricular septum,left ventricular posterior wall thickness and left ventricular mass were used as the indicators of target organ damage.Results The SBP,DBP,and PP were significantly lower in groups A-D after treatment than before treatment（P〈0.01）.The baPWV was significantly slower and the left ventricular ventricular thickness was significantly thicker in group C than in groups A,B and D（9.7±4.4mmvs 10.5±4.0mm,10.7±4.5mm and 10.3±4.7mm,P=0.006）.Conclusion Treatment of simple systolic hypertension can not only reduce hypertension but also improve pulse wave reflection due to decreased or increased conducting artery stiffness.

关 键 词：利尿药 高血压 动脉硬化 药物疗法 联合 危险因素 

分 类 号：R544.1[医药卫生—心血管疾病]