奥美沙坦与替米沙坦治疗老年轻、中度原发性高血压患者8周的疗效比较  

Comparison the efficacy and safety between olmesartan and telmisartan in treatment of elderly patients with mild to moderate essential hypertension

作　　者：岳玲[1] 丁薇[1] 倪秀石[1] 

机构地区：[1]上海交通大学附属上海市第一人民医院老年科,上海200080

出　　处：《中国临床保健杂志》2017年第1期33-36,共4页Chinese Journal of Clinical Healthcare

摘　　要：目的通过与替米沙坦比较评价奥美沙坦治疗老年轻、中度原发性高血压的安全性及临床效果。方法采用随机双盲对照平行分组的方法共入选150例老年轻中度高血压患者,按1∶1比例随机分为两组。分别接受奥美沙坦20 mg或替米沙坦80 mg,1次/天。连续用药4周后进行血压评价,如果患者舒张压(DBP)仍≥90 mm Hg(1 mm Hg=0.133 k Pa),则试验药物剂量加倍,直至8周试验结束;治疗4周后DBP<90 mm Hg的患者则维持原剂量继续治疗至第8周。结果治疗4周后,奥美沙坦组坐位DBP谷值平均下降11.35mm Hg,替米沙坦组平均下降8.47 mm Hg,两组间差异有统计学意义(P<0.05);治疗8周后,奥美沙坦组坐位DBP谷值平均下降13.01 mm Hg,替米沙坦组平均下降10.87 mm Hg,两组间差异有统计学意义(P<0.05);治疗4周后,两组有效病例数和有效率相当,P>0.05;治疗8周后,奥美沙坦组有效数为65例(86.7%),替米沙坦组有效数为54例(72.0%),两组间差异有统计学意义(P<0.05);随着治疗的进展,肾小球滤过率、肌酐清除率较治疗前升高,尿素氮、血肌酐明显降低(P<0.01),奥美沙坦组较替米沙坦组下降更显著(P<0.01)。替米沙坦组不良反应总发生率10.7%显著高于奥美沙坦组的2.7%(P<0.05)。结论奥美沙坦每日口服20~40 mg能够有效地治疗治疗老年轻、中度原发性高血压。较每日口服替米沙坦80~160 mg/d效果更值得肯定,可有效保护肾功能,且耐受性好,安全可靠。Objective To evaluate the clinical effect and safety of Olmesartan in treatment of mild, moderate primary hypertension. Methods 150 patients with mild and moderate hypertension were randomly divided into two groups, each was 75 cases. The control group was treated with only olmesartan ,20 mg/time, 1 timc/d. The control group was given Telmisartan,40 mg,/time, 1 time/d. Compared the change of blood pressure and the incidence of adverse reactions after 2 months. Results The total efficiency of two groups were 98.7 % and 89.3 %, respectively, the difference was significant （P 〈 0.05 ）. At the end of the treatment, the two groups had the increase of the dosage of 22.7% , 8% , and the difference of the two groups was statistically significant （P 〈 0.01 ）. After treatment, 24 h mean blood pressure were statistically decreased （ P 〈 0.05 ） ; And after 2 w, the reduction range of blood pressure between in two groups had significant difference （ P 〈 0.05 ）. With the development of treatment, GFR, CCr has increased, BUN and Ser had decreased the observation group was significantly lower than the control group （P 〈 0.01 ）. The total incidence rate of control group was 10.7% ,that was significant higher than that with observation group of 2.7% （ P 〈 0.05 ）. Conclusion The Olmesartan is an effective drug in the treatment of elderly patients with mild, moderate primary hy- pertension with better safe and reliable.

关 键 词：高血压 血管紧张素Ⅱ2型受体拮抗剂 老年人 

分 类 号：R544.11[医药卫生—心血管疾病]