疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2014年
4期
354-357
,共4页
骆琼%马丽%潘云红%贾海珍%韩红彦
駱瓊%馬麗%潘雲紅%賈海珍%韓紅彥
락경%마려%반운홍%가해진%한홍언
高血压病%培哚普利%氨氯地平%氢氯噻嗪%动态血压%胱抑素%尿酸%老年人
高血壓病%培哚普利%氨氯地平%氫氯噻嗪%動態血壓%胱抑素%尿痠%老年人
고혈압병%배타보리%안록지평%경록새진%동태혈압%광억소%뇨산%노년인
Hypertension%Perindopril%Amlodipine%Hydrochlorothiazide%Ambulatary blood pressure%Cystatin%Uric acid%Elderly
目的：探讨培哚普利联合氨氯地平或氢氯噻嗪治疗老年高血压患者的疗效、安全性及对血清钾、胱抑素及尿酸的影响。方法选取老年高血压患者60例，随机分为2组，分别给以培哚普利＋氨氯地平（氨氯地平组， n ＝30）或培哚普利＋氢氯噻嗪（氢氯噻嗪组， n ＝30）进行降压治疗，观察入选时和治疗8周后24 h动态血压及血钾、血清胱抑素和血尿酸水平。结果与治疗前相比，氨氯地平组和氢氯噻嗪组血压指标均有降低（氢氯噻嗪组dDBP除外），且前者的降低幅度明显高于后者（ P ＜0览．05）。治疗后，氨氯地平组血压达标率高于氢氯噻嗪组（90．0％ vs．76．7％， P ＜0．05）；2组药物降压谷峰比值均大于50％，氨氯地平组收缩压降压谷峰比（ SBPT/P）大于氢氯噻嗪组（P ＜0．05），舒张压降压谷峰比（DBPT/P）略大于氢氯噻嗪组，差异无统计学意义（ P ＞0．05）；与用药前相比，2组治疗后血压平滑指数均有提高（ P ＜0．05），且氨氯地平组高于氢氯噻嗪组（ P ＜0．05）。氨氯地平组治疗后胱抑素水平明显降低（ P ＜0．05），氢氯噻嗪组亦有降低，但差异无统计学意义（ P ＞0．05）；2组血钾、尿酸水平均无明显变化（P ＞0．05）。结论培哚普利联合氨氯地平或氢氯噻嗪均能明显降低老年高血压患者血压水平，但前者降压效果优于后者。培哚普利联合氨氯地平在提高血压平滑指数、改善血压昼夜节律、平稳降压、肾脏保护等方面作用更强，可能更适合老年高血压患者。
目的：探討培哚普利聯閤氨氯地平或氫氯噻嗪治療老年高血壓患者的療效、安全性及對血清鉀、胱抑素及尿痠的影響。方法選取老年高血壓患者60例，隨機分為2組，分彆給以培哚普利＋氨氯地平（氨氯地平組， n ＝30）或培哚普利＋氫氯噻嗪（氫氯噻嗪組， n ＝30）進行降壓治療，觀察入選時和治療8週後24 h動態血壓及血鉀、血清胱抑素和血尿痠水平。結果與治療前相比，氨氯地平組和氫氯噻嗪組血壓指標均有降低（氫氯噻嗪組dDBP除外），且前者的降低幅度明顯高于後者（ P ＜0覽．05）。治療後，氨氯地平組血壓達標率高于氫氯噻嗪組（90．0％ vs．76．7％， P ＜0．05）；2組藥物降壓穀峰比值均大于50％，氨氯地平組收縮壓降壓穀峰比（ SBPT/P）大于氫氯噻嗪組（P ＜0．05），舒張壓降壓穀峰比（DBPT/P）略大于氫氯噻嗪組，差異無統計學意義（ P ＞0．05）；與用藥前相比，2組治療後血壓平滑指數均有提高（ P ＜0．05），且氨氯地平組高于氫氯噻嗪組（ P ＜0．05）。氨氯地平組治療後胱抑素水平明顯降低（ P ＜0．05），氫氯噻嗪組亦有降低，但差異無統計學意義（ P ＞0．05）；2組血鉀、尿痠水平均無明顯變化（P ＞0．05）。結論培哚普利聯閤氨氯地平或氫氯噻嗪均能明顯降低老年高血壓患者血壓水平，但前者降壓效果優于後者。培哚普利聯閤氨氯地平在提高血壓平滑指數、改善血壓晝夜節律、平穩降壓、腎髒保護等方麵作用更彊，可能更適閤老年高血壓患者。
목적：탐토배타보리연합안록지평혹경록새진치료노년고혈압환자적료효、안전성급대혈청갑、광억소급뇨산적영향。방법선취노년고혈압환자60례，수궤분위2조，분별급이배타보리＋안록지평（안록지평조， n ＝30）혹배타보리＋경록새진（경록새진조， n ＝30）진행강압치료，관찰입선시화치료8주후24 h동태혈압급혈갑、혈청광억소화혈뇨산수평。결과여치료전상비，안록지평조화경록새진조혈압지표균유강저（경록새진조dDBP제외），차전자적강저폭도명현고우후자（ P ＜0람．05）。치료후，안록지평조혈압체표솔고우경록새진조（90．0％ vs．76．7％， P ＜0．05）；2조약물강압곡봉비치균대우50％，안록지평조수축압강압곡봉비（ SBPT/P）대우경록새진조（P ＜0．05），서장압강압곡봉비（DBPT/P）략대우경록새진조，차이무통계학의의（ P ＞0．05）；여용약전상비，2조치료후혈압평활지수균유제고（ P ＜0．05），차안록지평조고우경록새진조（ P ＜0．05）。안록지평조치료후광억소수평명현강저（ P ＜0．05），경록새진조역유강저，단차이무통계학의의（ P ＞0．05）；2조혈갑、뇨산수평균무명현변화（P ＞0．05）。결론배타보리연합안록지평혹경록새진균능명현강저노년고혈압환자혈압수평，단전자강압효과우우후자。배타보리연합안록지평재제고혈압평활지수、개선혈압주야절률、평은강압、신장보호등방면작용경강，가능경괄합노년고혈압환자。
Objective To evaluate the efficacy and safety of perindopril combined with amlodipine or hydrochlorothia -zide in elderly hypertensive patients ,observe its infcuence on serum potassium ,Cystatin and uric acid .Methods Selected 60 cases of elderly hypertensive patients , they were randomly divided into two groups , given perindopril +amlodipine ( amlodip-ine group, n =30) or perindopril +hydrochlorothiazide (HCTZ group, n =30) antihypertensive treatment respectively , ob-served 24 h ambulatory blood pressure , detect serum potassium , serum cystatin and blood uric acid levels before and after treatment begin and eight weeks after treatment .Results Compared with before treatment , amlodipine and hydrochlorothiazide in blood pressure indicators were lower ( except hydrochlorothiazide group dDBP ) , and the former reduced rate significantly higher than the latter( P <0.05).After treatment, the amlodipine group was higher than standard blood pressure hydrochlo-rothiazide group (90.0%vs.76.7%, P <0.05).2 group antihypertensive drugs trough to peak ratios were greater than 50%, systolic blood pressure amlodipine group trough to peak ratio ( SBPT/P) is greater than the hydrochlorothiazide group (P <0.05), diastolic blood pressure trough to peak ratio (DBPT /P) is slightly larger than hydrochlorothiazide group , the difference was not statistically significant ( P >0.05).Compared with before treatment , after treatment, the two groups had improved blood pressure smoothness index ( P <0.05), and the amlodipine group than hydrochlorothiazide group ( P <0.05).After amlodipine treatment cystatin levels were significantly lower ( P <0.05), hydrochlorothiazide group also de-creased, but the difference was not statistically significant ( P >0.05).Uric acid levels in the two groups had no significant change in serum potassium ( P >0.05).Conclusion Perindopril and amlodipine or hydrochlorothiazide can significantly re-duce blood pressure in elderly hypertensive patients , but the former has better antihypertensive effect than the latter .Perindopril amlodipine acid in smoothness index raise blood pressure , improve blood pressure circadian rhythm , stable blood pressure , kidney and other aspects of the role of stronger protection may be more suitable for elderly patients with hypertension .
