氯沙坦与氨氯地平在老年原发性高血压患者中的应用  

Application of Losartan and Amlodipine in Elderly Essential Hypertension

作　　者：杨智敏 陈颖 张艺羡 冯惠平 YANG Zhimin;CHEN Ying;ZHANG Yixian;FENG Huiping(Department of Pharmacy,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou Fujian 363000,China)

机构地区：[1]福建医科大学附属漳州市医院药学部,福建漳州363000

出　　处：《中国卫生标准管理》2023年第19期141-145,共5页China Health Standard Management

摘　　要：目的探究氯沙坦与氨氯地平对老年原发性高血压患者的疗效及对血管内皮功能的影响。方法选取2021年1—12月福建医科大学附属漳州市医院收治的90例老年原发性高血压患者为研究对象,按照随机数字表法分为A、B、C组,每组各30例。A组患者只服用氯沙坦治疗,B组只服用氨氯地平治疗,C组患者服用小剂量的氯沙坦加氨氯地平治疗。比较三组治疗后组内及组间治疗疗效,比较治疗前后血压[收缩压(systolic blood pressure,SBP)和舒张压(diastolic blood pressure,DBP)]变化情况;血管内皮功能指标[血浆一氧化氮(nitric oxide,NO)、内皮素-1(endothelin 1,ET-1)、血栓素A2(thromboxane A2,TXA2)]及治疗后不良反应发生率。结果三组患者治疗后SBP、DBP及血清ET-1、TXA2水平均明显下降(P<0.05),且C组显著低于A、B两组(P<0.05);C组总有效率显著高于A、B两组(P<0.05);治疗后血液中NO含量显著提升(P<0.05),且C组显著高于A、B两组(P<0.05);三组患者在治疗期间不良反应发生率均较低,组间差异无统计学意义(P>0.05)。结论氯沙坦与氨氯地平用于治疗老年原发性高血压可获得较好的疗效,且应用小剂量氯沙坦联合氨氯地平可进一步改善血压控制效果及血管内皮功能。Objective To explore the therapeutic efficacy of losartan and amlodipine in the treatment of elderly essential hypertension and the influence on vascular endothelial function.Methods A total of 90 elderly patients with essential hypertension admitted to Zhangzhou Affiliated Hospital of Fujian Medical University from January to December 2021 were selected as the study subjects and were divided into groups A,B and C according to the random number table method,with 30 cases in each group.Patients in group A only received losartan treatment,patients in group B only received amlodipine treatment,and patients in group C were given low-dose losartan plus amlodipine treatment.The therapeutic efficacy after treatment,blood pressure indicators[systolic blood pressure(SBP),diastolic blood pressure(DBP)]and vascular endothelial function indicators[plasma nitric oxide(NO),endothelin 1(ET-1),thromboxane A2(TXA2)]before and after treatment and incidence rates of adverse reactions after treatment were compared among the three groups.Results The SBP,DBP and serum ET-1 and TXA2 in the three groups were significantly decreased after treatment(P<0.05),and the above indicators in group C were significantly lower than those in groups A and B(P<0.05).The total effective rate was significantly higher in group C than that in groups A and B(P<0.05).After treatment,the blood NO level was significantly increased(P<0.05),and the level in group C was significantly higher than that in group A and group B(P<0.05).The incidence rates of adverse reactions in the three groups were lower during treatment,and there were no statistical differences among the three groups(P>0.05).Conclusion Losartan and amlodipine can achieve good therapeutic effects in the treatment of elderly essential hypertension,and low-dose losartan combined with amlodipine can further improve the blood pressure control effect and vascular endothelial function.

关 键 词：氯沙坦 氨氯地平 老年患者 原发性高血压 血管内皮功能 不良反应 

分 类 号：R544[医药卫生—心血管疾病]