比较不同剂量非洛地平及与氯沙坦联合用药的疗效和耐受性  

Comparison of efficacy and tolerability of felodipine ER monotherapy and combined felodipine ER and losartan in patients with essential hypertension

作　　者：巴建明[1] 李新华[1] 宋亚香[1] 朱开元[1] 

机构地区：[1]同济大学附属铁路医院肾脏内科,上海200072

出　　处：《上海医学》2003年第6期299-301,共3页Shanghai Medical Journal

摘　　要：目的　比较单独使用不同剂量非洛地平缓释片 (波依定 )和小剂量非洛地平缓释片与氯沙坦联合应用对原发性高血压患者的降压效果、不良反应及对有效肾血浆流量 (ERPF)的影响。方法　将伴或不伴肾功能损害的原发性高血压患者随机分成 3组。A组 :口服非洛地平缓释片 5mg/次 ,每日 1次 ;B组 :口服非洛地平缓释片 5mg/次 +氯沙坦 5 0mg/次 ,每日 1次 ;C组 :口服非洛地平缓释片 10mg/次 ,每日 1次 ;3组均连续治疗10周 ,每 2周观察 1次血压 ,治疗前后各测 1次ERPF ,比较其降压幅度、不良反应及ERPF。结果　各组血压从第 2周起均有显著下降 ,但组间差异无显著性 ;第 10周后A、C两组间的差异有显著性。B组的不良反应明显低于其他 2组。对ERPF的影响各组间的差异无显著性。结论　不同剂量非洛地平缓释片单独应用或小剂量与氯沙坦联合应用 ,其降压效果均明显 ,且较大剂量非洛地平缓释片长时间应用 ,降压作用更明显 ;联合用药的耐受性比单独使用好。Objective To compare the efficacy and tolerability of felodipine ER monotherapy and combined felodipine ER and losartan in patients with essential hypertension. Methods 60 patients with essential hypertension were randomly allocated to 10 week treatment with either monotherapy (5 mg or 10 mg felodipine ER, once daliy) , or combined therapy (5 mg felodipine ER + 50 mg losartan, once daliy ). Blood pressure and the adverse reactions were assessed every 2 weeks. Effective renal plasma flow(ERPF) was measured at the beginning and the end of the treatment. Results After 2 weeks treatment, the three groups had significant reduction of systolic/diastolic blood pressure (BP) in sitting posture. There were no significant differences between the three groups. Reduction of systolic/diastolic BP in sitting posture at 10 weeks was more significant with 10 mg felodipine monotherapy group than the other two groups. The adverse effects occurred less oftenly in patients taking combined therapy than in those taking felodipine alone. Some differences in ERPF was observed in either of the three groups, but this difference was not significant. Conclusion Our study shows that combined therapy is better tolerated than long term monotherapy in higher dosage, either felodipine monotherapy or combined with losartan can maintain the ERPF in patients with essential hypertension.

关 键 词：原发性高血压 非洛地平 氯沙坦 联合用药 疗效 

分 类 号：R969.4[医药卫生—药理学]