氢氯噻嗪联合厄贝沙坦治疗老年原发性高血压的效果及对血压与生活质量的影响  

Effect of hydrochlorothiazide combined with irbesartan in the treatment of elderly essential hypertension and its influence on blood pressure and quality of life

作　　者：齐吉芳 毕鹏 李飞兵 QI Jifang;BI Peng;LI Feibing(Department of Cardiovascular Medicine,Jingdezhen Hospital of Traditional Chinese Medicine,Jiangxi Province,Jingdezhen 333000,China)

机构地区：[1]江西省景德镇市中医医院心血管内科,333000

出　　处：《临床合理用药杂志》2024年第21期21-24,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察氢氯噻嗪联合厄贝沙坦治疗老年原发性高血压的效果及对患者血压与生活质量的影响。方法 选取2022年5月—2023年5月景德镇市中医医院收治的老年原发性高血压患者76例,根据随机数字表法分为单独采用厄贝沙坦片治疗的厄贝沙坦组(n=38)和采用氢氯噻嗪片联合厄贝沙坦片治疗的联合用药组(n=38)。2组均持续治疗3个月。比较2组患者的临床疗效,治疗前后血压、心率与血清N末端脑钠肽前体(NT-proBNP)、血钾水平及世界卫生组织生存质量量表简表评分,不良反应。结果 联合用药组治疗总有效率为94.74%,高于厄贝沙坦组的73.68%(χ^(2)=6.333,P=0.012)。治疗3个月后,2组收缩压、舒张压、心率及血清NT-proBNP、血钾水平较治疗前均下降,且联合用药组低于厄贝沙坦组(P<0.01);2组社会、躯体、环境、心理和综合评分均升高,且联合用药组高于厄贝沙坦组(P<0.05或P<0.01)。联合用药组不良反应总发生率为7.89%,低于厄贝沙坦组的26.32%(χ^(2)=4.547,P=0.033)。结论 老年原发性高血压患者采用氢氯噻嗪联合厄贝沙坦治疗效果显著,可明显降低患者血压,改善血清NT-proBNP和血钾水平,提高患者生活质量,且用药安全可靠。Objective To observe the effect of hydrochlorothiazide combined with irbesartan in the treatment of elderly essential hypertension and its influence on blood pressure and quality of life.Methods A total of 76 elderly patients with essential hypertension admitted to Jingdezhen Hospital of Traditional Chinese Medicine from May 2022 to May 2023 were selected and divided into the irbesartan group(n=38) and the combined treatment group(n=38) according to the random number table method.The irbesartan group was treated with irbesartan tablets,and the combined treatment group was treated with hydrochlorothiazide tablets combined with irbesartan tablets.Both groups received continuous treatment for 3 months.Clinical efficacy,blood pressure,heart rate,serum NT-proBNP,potassium levels,WHOQOL-BREF scores before and after treatment,and adverse reactions were compared between the two groups.Results The total effective rate in the combined treatment group was 94.74%,which was higher than 73.68% in the irbesartan group(χ^(2)=6.333,P=0.012).After 3 months of treatment,systolic blood pressure,diastolic blood pressure,heart rate,serum NT-proBNP and potassium levels in the two groups were lower than those before treatment,and the combined treatment group were lower than those of the irbesartan group(P<0.01);The social scores,physical scores,environmental scores,psychological scores and comprehensive scores of the two groups were higher than those before treatment,and the combined treatment group were higher than those of the irbesartan group(P<0.05 or P<0.01).The total incidence of adverse reactions in the combined treatment group was 7.89%,which was lower than 26.32% in the irbesartan group(χ^(2)=4.547,P=0.033).Conclusion Hydrochlorothiazide combined with irbesartan can lower blood pressure,improve serum NT-proBNP and potassium levels in the treatment of elderly essential hypertension patients,enhance the quality of life of patients,and the medication is safe and reliable.

关 键 词：原发性高血压 老年人 氢氯噻嗪 厄贝沙坦 血压 生活质量 

分 类 号：R544.11[医药卫生—心血管疾病]