CAJ | 학술논문

目的研究氢氯噻嗪(HCTZ)与螺内酯或卡托普利长期联用对高血压患者血清高敏C-反应蛋白(hsCRP)水平的影响.方法采用多中心、随机、平行对照研究,选择轻中度高血压患者,经安慰剂洗脱2周和HCTZ12.5 mg口服1 A./d导入6周后随机分为HCTZ(12.5 mg口服1次/d)组、螺内酯组(HCTZ 12.5mg口服1次/d+螺内酯20 mg口服1 K/d)和卡托普利组(HCTZ 12.5 mg口服1冼/d+卡托普利25 mg口服2次/d).随访1年末,因已公认联合治疗效果优于单药治疗,故将HCTZ组患者随机分入螺内酯组和卡托普利组.治疗期间每月随访1次,监测血压,每年行血清hsCRP水平检测.共随访4年.4年末进行分析,将坚持服用试验药物的患者视为治疗组,未坚持服用者视为对照组,比较两组治疗前后血清hsCRP水平的变化.结果 4年末,治疗组患者的血压及血清hsCRP水平较基线显著下降,且与对照组比较下降幅度差异有统计学意义(P<0.05或0.01).多因素分析结果表明,治疗前收缩压和血清hsCRP水平、治疗后收缩压下降值及年龄是影响血清hsCRP水平下降的主要因素(均P<0.05).结论 HCTZ与螺内酯或卡托普利长期联用在有效降低患者血压的同时,能显著降低其血清hsCRP水平,收缩压下降值是影响血清hsCRP水平的主要因素.
목적 연구경록새진(HCTZ)여라내지혹잡탁보리장기련용대고혈압환자혈청고민C-반응단백(hsCRP)수평적영향.방법 채용다중심、수궤、평행대조연구,선택경중도고혈압환자,경안위제세탈2주화HCTZ12.5 mg구복1 A./d도입6주후수궤분위HCTZ(12.5 mg구복1차/d)조、라내지조(HCTZ 12.5mg구복1차/d+라내지20 mg구복1 K/d)화잡탁보리조(HCTZ 12.5 mg구복1승/d+잡탁보리25 mg구복2차/d).수방1년말,인이공인연합치료효과우우단약치료,고장HCTZ조환자수궤분입라내지조화잡탁보리조.치료기간매월수방1차,감측혈압,매년행혈청hsCRP수평검측.공수방4년.4년말진행분석,장견지복용시험약물적환자시위치료조,미견지복용자시위대조조,비교량조치료전후혈청hsCRP수평적변화.결과 4년말,치료조환자적혈압급혈청hsCRP수평교기선현저하강,차여대조조비교하강폭도차이유통계학의의(P<0.05혹0.01).다인소분석결과 표명,치료전수축압화혈청hsCRP수평、치료후수축압하강치급년령시영향혈청hsCRP수평하강적주요인소(균P<0.05).결론 HCTZ여라내지혹잡탁보리장기련용재유효강저환자혈압적동시,능현저강저기혈청hsCRP수평,수축압하강치시영향혈청hsCRP수평적주요인소.
Objective To study the effect of combination of Hydrochlorothiaside (HCTZ) with Captopril or spironolactone on serum high-sensitivity C-reactive protein (hsCRP) in hypertension patients. Methods A multi-centre, random and parallel control study was applied in this study. Slight and moderate hypertension patiens were se-lected. The patients were treated with placebo for two weeks and HCTZ 12.5 mga day for 6 weeks,wbo were then randomly divided into HCTZ group(12.5 mg once a day), spironolactone group(HCTZ 12.5 mg once a day + Spi-ronolactone 20 rag once a day) and captopril group(HCTZ 12.5 mg once a day + Captopril 25 rag twice a day) . By the end of one-year follow up, HCTZ group was randomly added to Spironolactone group and Captopril group because combination therapy was superior to single medication,which was recognized. During the treatment, the patients were followed up once a month ,for monitoring blood pressure, and serum hsCRP level was measured every year. Follow-up last for 4 years. By the end of 4 years, the patients were divided into treatment group and control group in order to compare the changes of serum hsCRP levels. Results At the end of 4 years, the blood pressure and serum hsCRP level were significantly decreased as compared with baseline, and were statistically different from that of control group (P <0.05 or 0.01). Multi-factor analysis showed that pre-treatment systolic blood pressue and serum hsCRP level, post-treatment decrease value of systolic blood pressue and age were the major influencing factors for the de-crease of serum hsCRP level(P < 0.05 for each). Conclusion The long-term combinaion of HCTZ with Spironolactone or Captopril not only effectivley decreases blood pressure but also decreases serum hsCRP level. The decrease value of systolic blood pressure is the major factor for influencing serum hsCRP level.