替米沙坦治疗轻中度原发性高血压的疗效和安全性的临床研究  

The Study of Safely and Efficacy by Telmisartan Therapy in Patientswith Essential Hypertension

作　　者：曾群英[1] 曾瑞曦[1] 高修仁[1] 许庆[1] 郑东诞[1] 廖新学[1] 陶军[1] 陈国伟[1] 

机构地区：[1]中山大学附属第一医院心内科,广州510080

出　　处：《中国医药导刊》2004年第1期50-53,共4页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨替米沙坦治疗轻、中度原发性高血压的临床疗效和安全性。方法:121例轻中度原发性高血压患者随机单盲分为两组,替米沙坦(治疗)组:61例,80mg/d,晨顿服。6周后未达显效者,加双氢氯噻嗪(HCTZ)12.5mg/d,疗程半年。氯沙坦(对照)组:60例,50mg/d,晨顿服,6周后未达显效者,加服HCTZ 12.5mg/d,疗程半年。治疗前后均进行偶测血压、动态血压(ABPM)、肝肾功能、血生化、血浆纤溶酶原激活物抑制剂-1(PAI-1)、纤维蛋白原(FG)、C-反应蛋白(CRP)、血尿酸(BUA)等检查,并观察心脑事件发生情况及药物不良反应。结果:替米沙坦(治疗)组:降压总有效率78.7％(48/61例),降压幅度25.6/14.6mmHg,谷/峰(T/P)比值:收缩压(SBP)0.88,舒张压(DBP)0.89,6周后未达显效者,加服HCTZ 2周后,达显效25％(9/36例);氯沙坦(对照)组:降压总有效率75％(45/60例),降压幅度22.1/12.1mmHg。T/P比值:SBP 0.86、DBP 0.87,6周后未达显效者,加服.HCTZ 2周达显效21.1％(8/38例),两组组间比较,降压幅度有明显差异(P7<0.05),ABPM中的24h SBP和24h DBP治疗后降低值,两组也有显著性差异(P<0.05);两组治疗后PAI-1、FG、CRP均较治疗前明显降低(P<0.01),但3项指标组间比较无显著性差异(P>0.05),两组治疗后BUA均较治疗前有明显降低(P<0.05),且氯沙坦组比替米?Objective:Toinvestigate the safety and efficacy by telmisartan thetapy in patients with mild or middle type essential hyper- tension. Methods: 121 patients with mild or middle type essential hypertension were divided into two groups randomly: Group one was given with 80mg telmisartan per day in the morning , group two was given with 50mg loaartan. Larsting 6 weeks treatment without remarkable effect,hydrochlorothiazide was added . The renal function, hepatic function, plasma electrolye , plasminogen activator inhibiter-1 (PAI-l), fibrinogen(FG), C-creatin protein(CRP), plasma uric-acid and ambulatory blood pressure were compared before and after treatment in the groups. The cardiovascular events or incidence of stroke and drug adverse reaction were following up for 6 months at least. Results: Results: In the group one the total effective rate of blood control was 78.7% (48/61 case). The degree of blood lowing was25.6/14.6mmHg. The trough-to peak(T/P) ratio was: Systolic blood pressure(SBP) 0.88,Diastolic blood pressure(DBP)0.89. Hydrochorothiazade (HCT) was taken in 9 cases who appeared inefficacy after 6 weeks telmisartan therapy and the remarkable efficacy was 25% after adding HCT.In the group two the total effective rate of blood control was 75.0% (45/60} and the blood lowing was 22.1/ 12. 1mmHg.The T/P ratio was: SBP 0.86,DBP 0.87.Hydrochorothizide was added when it appeared inefficacy in 8 cases after 6 weeks losartan therapy and the remarkable efficacy was 21.1%. Comparing to group two, group one had significantly difference in degree of blood lowing (P<0.05) and had significantly difference on mean SBP and mean DBP by ambulatory monitoring(P<0.05). The PAI-1, FG , CRP were remarkably lowing after treatment in either telmisartan or losartan group (P<0.05) but telmisartan was more remarkable(P<0.05). After 6 months following up the cardiovascular events and stroke were similar in two groups. The drag adverse reaction was mild and similar in two groups. Conclusion: There are safety, efficacy, stabili

关 键 词：替米沙坦 药物治疗 轻中度原发性高血压 安全性 氯沙坦 双氢氯噻嗪 

分 类 号：R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]