托拉塞米治疗原发性高血压的临床评价  

Efficacy and Safety of Torasemide in Patients with Mild to Moderate Essential Hypertension

作　　者：苏绮[1] 李一石[1] 陈君柱[2] 黄德嘉[3] 樊朝美[1] 孙兴昌[1] 胡晓晟[2] 陈晓平[3] 龚培[1] 成小如[1] 华潞 

机构地区：[1]中国医学科学院阜外心血管病医院临床药理研究室,北京100037 [2]浙江大学医学院第一附属医院心内科,浙江杭州310003 [3]华西医科大学附属医院心内科,四川成都610041

出　　处：《高血压杂志》2003年第4期325-328,共4页Chinese Journal of Hypertension

基　　金：国家"十五"重大科技专项课题 ( 2 0 0 2AA2Z34 11)

摘　　要：目的　评价托拉塞米 (torasemide)治疗轻、中度原发性高血压的疗效和安全性。方法　选择门诊轻、中度原发性高血压患者 (坐位舒张压 (DBP) 95mmHg～ 1 1 5mmHg) ,以随机、双盲、平行对照的方法 ,经 1～ 2周药物洗脱期后 ,随机分入托拉塞米组或吲哒帕胺缓释片剂 (indapamide)组 ,分别服用托拉塞米 5mg每日一次或吲哒帕胺缓释片剂2 5mg每日一次。治疗 4周末坐位DBP <90mmHg者结束试验 ;坐位DBP≥ 90mmHg者剂量分别加倍至托拉塞米1 0mg每日一次或吲哒帕胺缓释片剂 5mg每日一次 ,继续服用 4周。于洗脱期末及治疗 2、4、6、8周测量诊室血压、心率并记录症状、体征 ;治疗期前、治疗第 2周及试验结束时进行实验室检查。结果　共 1 30例合格的原发性高血压患者进入随机分组 ,1 1 8例完成试验 ,其中托拉塞米组 56例 (4周结束者 30例 ,8周结束者 2 6例 ) ,吲哒帕胺缓释片剂组 62例 (4周结束者 41例 ,8结束者周 2 1例 )。服药 4周后 ,总有效率托拉塞米组 67 86 % (38/ 56例 ) ,吲哒帕胺缓释片剂组 72 58% (45/ 62例 ) ;治疗 8周后 ,加量者总有效率托拉塞米组 34 62 % (9/ 2 6例 ) ,吲哒帕胺缓释片剂组61 90 % (1 3/ 2 1例 ) ,组间比较均无差异 (P =1 0 0 ,P =0 67)。两组药后 2、4、6、8周坐位舒张压的下降幅?Objective To evaluate the antihypertensive effect and safety of torasemide in Chinese patients with mild to moderate essential hypertension Methods After 1～2 weeks wash out, patients with mild to moderate essential hypertension(seated DBP 95～115 mmHg), were randomly assigned to received torasemide 5 mg or indapamide 2 5 mg once a day for 4 weeks, followed by a double dose for another 4 weeks in patients whose seated DBP were still ≥90 mmHg Blood pressure, heart rate, symptoms and signs were examined at the end of wash out and 2, 4, 6, 8 weeks Laboratory examinations were performed at baseline, 2 weeks and the end of the trial Results 130 essential hypertensive patients were recruited and randomized to receive either torasemide group ( n =64) or indapamide group ( n =66) 118 patients completed the trial, 56 patients in torasemide group(30 finished at the end of 4 weeks and 26 finished at the end of 8 weeks) and 62 in indapamide group(41 finished at the end of 4 weeks and 21 finished at the end of 8 weeks) At the end of 4 weeks, the effective rate was 67 86% in torasemide group and 72 58% in indapamide group At the end of 8 weeks, the effective rate in those whose dosage was doubled was 34 62% in torasemide group and 61 90% in indapamide group No statistical difference was found ( P =0 67) The decrease of seated DBP was of no differece between the two groups at the end of 2, 4, 6, 8 weeks The values of serum potassium, sodium, chloride were lower in indapamide group than those in torasemide group at 2 weeks and the end of the trial ( P <0 01 or P <0 05) Conclusion Torasemide 5 mg/d～10 mg/d is as effective as indapamide 2 5 mg/d～5 mg/d in patients with mild to moderate essential hypertension The impact of torasemide to serum electrolyte is much less than that of indapamide

关 键 词：托拉塞米 吲哒帕胺 原发性高血压 

分 类 号：R544.1[医药卫生—心血管疾病] R972[医药卫生—内科学]