螺内酯联合常规降压方案治疗难治性高血压的效果分析  

Analysis on Effect of Spironolactone Combined with Conventional Antihypertensive Regimen in Treatment of Refractory Hypertension

作　　者：黎梨 Li Li(The Second People's Hospital of Ganyu District of Lianyungang City(Qingkou Central Health Center of Ganyu District of Lianyungang City),Lianyungang 222100,Jiangsu Province,China)

机构地区：[1]连云港市赣榆区第二人民医院(连云港市赣榆区青口中心卫生院),江苏连云港222100

出　　处：《中国社区医师》2025年第8期45-47,共3页Chinese Community Doctors

摘　　要：目的:分析螺内酯联合常规降压方案治疗难治性高血压(RH)的效果。方法:选择60例RH患者展开研究,均为2021年1月—2023年1月连云港市赣榆区第二人民医院收治,随机将患者分为对照组(实施常规降压方案治疗)和治疗组(在对照组基础上给予螺内酯治疗),每组纳入30例。比较两组治疗效果。结果:治疗组治疗总有效率高于对照组(P=0.023)。治疗后,两组收缩压、舒张压降低,且治疗组低于对照组(P<0.05)。治疗后,两组肾素活性、血管紧张素Ⅱ、醛固酮水平降低,且治疗组低于对照组(P<0.05)。治疗后,两组左室舒张末期内径、左室收缩末期内径、室间隔厚度均减小,且治疗组左室舒张末期内径、左室收缩末期内径小于对照组(P<0.05)。两组不良反应总发生率无明显差异(P>0.05)。结论:螺内酯联合常规降压方案治疗RH效果显著,可降低血压,改善肾素-血管紧张素-醛固酮系统指标和心功能,且安全性较高。Objective:To analyze the effect of spironolactone combined with conventional antihypertensive regimen in treatment of refractory hypertension(RH).Methods::A total of 60 RH patients were selected for treatment,all of whom were admitted to the Second People's Hospital of Ganyu District,Lianyungang City from January 2021 to January 2023,and the patients were randomly divided into control group(treated with conventional antihypertensive regimen)and treatment group(treated with spironolactone on the basis of the control group),and 30 cases were included in each group.The control group implemented conventional antihy⁃pertensive regimen,and the treatment group was treated with spironolactone on the basis of the control group.The treatment ef⁃fects were compared between the two groups.Results:The total effective rate of treatment in the treatment group was higher than that in the control group(P=0.023).After treatment,the systolic blood pressure and diastolic blood pressure in the two groups de⁃creased,and these parameters in the treatment group were lower than those in the control group(P<0.05).After treatment,the lev⁃els of renin activity,angiotensinⅡand aldosterone in the two groups decreased,and the levels in the treatment group were lower than those in the control group(P<0.05).After treatment,the left ventricular end-diastolic diameter,left ventricular end-systolic diameter and interventricular septal thickness in the two groups decreased,and the left ventricular end-diastolic diameter and left ventricular end-systolic diameter in the treatment group were smaller than those in the control group(P<0.05).There was no sig⁃nificant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Spironolactone com⁃bined with conventional antihypertensive regimen has a significant effect in the treatment of RH,which can reduce blood pressure,improve renin-angiotensin-aldosterone system indexes and cardiac function,and has a high safety.

关 键 词：难治性高血压 螺内酯 氢氯噻嗪 培哚普利 非洛地平 

分 类 号：R544.1[医药卫生—心血管疾病]