【摘要】 目的 观察氯沙坦与吲哒帕胺单独应用或联合用药对原发性高血压患者血压、血钾、血糖、尿酸、血脂的影响。方法 将符合诊断标准的150例老年高血压患者电脑随机分为3组,每组50例,进行用药前后自身对照试验,8周后检测各组血压、血钾、血糖、尿酸、血脂值。结果 3组治疗后收缩压和舒张压均较前明显降低,联合治疗组降压幅度最大,氯沙坦组和联合治疗组治疗后尿酸值较治疗前降低,吲哒帕胺组治疗后血钾值较治疗前降低。结论 氯沙坦与吲哒帕胺联合应用不仅具有协同降压作用,而且能降低尿酸,减轻吲哒帕胺引起的低钾血症。
【关键词】 高血压;临床试验;氯沙坦;吲哒帕胺
Comparison of the effects of losartan and Indapamide alone and combined treatment on the elder hypertension.
YU Qi.The Community Health Service Center of Xujiahui,Shanghai 200030,China
[Abstract] Objective To observe the effects of Indapamide and losartan alone and combined treatment on the elder patients with hypertension,hypokalemia,hyperglycemia,uric acid,lipid,ect.Methods One hundered and fifty patients with hypertension were randomly divided into three groups,with each of 50 cases.The levels of blood pressure,hypokalemia,blood sugar,uric acid,lipide were examined before and after treatment.Results After 8 weeks the systolic and diastolic blood pressure were significantly lower.Antihypertensive treatment group is the best,the levels of hypokalemia is lower after treatment in the Indapamide group,the levels of uric acid is also lower in the losartan group and antihypertensive group.Conclusion Losartan and Indapamide combined treatment not only coordinate to decrease blood pressure but also reduce uric acid,reduce the effect of hypokalemia caused by Indapamide.
[Key words] losartan;indapamide;hypertension;potassium;combination
根据《中国高血压病防治指南》的规定,年龄超过60岁,达到高血压诊断标准者即为老年高血压[1]。众所周知,老年高血压因为其发病率高,致死或致残而严重地威胁老年人的生活质量。合理应用降压药物是保护重要器官不受损伤,减少心力衰竭、肾衰竭、脑中风事件发生的重要手段[2]。然而现有的抗高血压药物,任何一种单独应用其有效率也只有50%~60%[3],且单一用药后机体代偿机制可产生反馈调节,如交感与RAS系统活化、水钠潴留等,可降低或抵消降压效果[4],因此联合用药受到重视。我们将小剂量氯沙坦与吲哒帕胺合用治疗老年高血压取得较好疗效,现介绍如下。
1 对象与方法
11 研究对象 根据1998年WHO高血压诊断标准,选择2003年1月~2004年12月在我院门诊治疗的高血压患者150例,男90例,女60例,年龄60~78岁,平均(658±92)岁,高血压病程5~22年,平均(12±7)年,高血压1级50例,高血压2级74例,高血压3级26例,经系统除外继发性高血压、脑卒中、心肌梗死、明显窦缓、控制不良糖尿病及肝肾损害者。将150例患者电脑随机分为吲哒帕胺组、氯沙坦组、联合用药组,每组50例,三组年龄、性别、高血压分级经统计学比较无差异,具有可比性(P>
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