吲哒帕胺与氢氯噻嗪分别联用氯沙坦治疗高血压伴左室肥厚比较  

Comparison of indapamide or hydrochlorothiazide respectively with losartan in combination therapy on patients with essential hypertension and left ventricular hypertrophy

作　　者：刘朝霞 姚峰 原广平 闫西艴[2] 张彦周[2] 汪涛 

机构地区：[1]郑州市市直机关医院心内科,河南郑州450007 [2]郑州大学附属第一医院心内科,河南郑州450003 [3]河南煤炭总医院心内科,河南郑州450001

出　　处：《临床荟萃》2003年第13期729-732,共4页Clinical Focus

摘　　要：目的　比较吲哒帕胺 (商品名 :寿比山 )联用氯沙坦 (商品名 :科素亚 )与氢氯噻嗪 (商品名 :双氢克尿噻 )联用氯沙坦长期治疗中、重度高血压的疗效和对左室肥厚 (LVH)、左室舒张功能的影响。方法　 86例高血压伴左室肥厚患者随机分为两组 ,停用降压药 1周。一组用吲哒帕胺 1.5～ 2 .5mg/d联用氯沙坦 5 0～ 10 0mg/d口服治疗 4 8周 ;另一组用氢氯噻嗪 12 .5～ 2 5mg/d联用氯沙坦 5 0～ 10 0mg/d口服治疗 4 8周。 结果　两组血压均显著下降 (P <0 .0 5 ) ,吲哒帕胺联用氯沙坦组和氢氯噻嗪联用氯沙坦组降压总有效率分别为 92 .9% ,90 .0 % (P >0 .0 5 )。两组均可改善LVH及左室舒张功能 (P <0 .0 1) ,但吲哒帕胺联用氯沙坦组改善更明显 ,(P <0 .0 1)。两组不良反应均较少 ,对血脂、血糖代谢的影响吲哒帕胺联用氯沙坦组略优于氢氯噻嗪联用氯沙坦组。结论　吲哒帕胺联用氯沙坦治疗中、重度高血压伴LVH患者的疗效和安全性优于氢氯噻嗪联用氯沙坦 。Objective To compare the efficacy of long term treatment with indapamide/losartan and low dose hydrochlorothiazide/losartan on blood pressure,left ventricular hypertrophy (LVH) and LV diastolic function in hypertensive patients with LVH.Methods Eighty six hypertensive patients with LVH were randomly divided into two groups.The first group received indapamide 1.25 2.5 mg/d and losartan 50 100 mg/d for 48 weeks.The second group received hydrochlorothiazide 12.5 25 mg/d and losartan 50 100 mg/d for 48 weeks.Results Blood pressure was significantly reduced in both groups (P> 0.05 ).The total effective rates were 92.9% in the first group and 90.0% in the second group (P> 0.05 ).The LVH and left ventricular diastolic functions in both groups were improved significantly (P< 0.01 ).But in the indapamide combination losartan group above targets of LVH and left ventricular diastolic function changes were more remarkable than those in the hydrochlorothiazide combination losartan group  (P<  0.01 ).Adverse reaction was mild in both groups,indapamide/losartan was superior to hydrochlorothiazide/losartan in reducing blood glucose and triglycerides profile.Conclusion Indapamide with losartan is more effective with less adverse reactions than hydrochlorothiazide with losartan in treating moderate to severe hypertesive patients with LVH, which may be an appropriate choice of long term antihypertensive therapy.

关 键 词：高血压 左心室肥大 心室功能 吲哒帕胺 氯沙坦 氢氯噻嗪 

分 类 号：R544.1[医药卫生—心血管疾病] R969.4[医药卫生—内科学]