CAJ | 학술논문

目的：探讨不同治疗方案治疗伴肾上腺增生高血压的临床疗效。方法将伴肾上腺增生高血压患者随机分为4组：A 组：硝苯地平控释片30 mg ＋螺内酯20 mg （n ＝30），B 组：硝苯地平控释片30 mg ＋螺内酯40 mg （n ＝31），C 组：硝苯地平控释片30 mg ＋厄贝沙坦片150 mg ＋螺内酯20 mg （n ＝29），D 组：硝苯地平控释片30 mg ＋厄贝沙坦片150 mg ＋安慰剂（n ＝29），出院后随访第1、2、3、4周及第2、3、6、9、12个月血压及电解质。评估各组治疗前后血压、电解质水平。结果（1）治疗12个月后4组收缩压下降幅度分别为13．4％、14．1％、18．0％、16．9％；舒张压下降幅度分别为17．5％、17．8％、24．7％、22．9％。（2）治疗第1、2、6、9、12个月 C 组收缩压低于其他各组，差异有统计学意义。（3）治疗第1、9、12个月 C 组舒张压低于其他各组，差异有统计学意义。（4）治疗后第6、9个月 B 组血钾高于其他组，第12个月 B 组、C 组血钾高于其他组，差异有统计学意义。（5）A 组显效率、有效率、无效率分别为66．7％、26．7％、6．6％，B 组为80．6％、16．1％、3．3％，C 组为86．2％、10．3％，3．5％，D 组为82．8％、13．8％、3．4％。（6）4组患者治疗前后血钾与血压均呈负相关。（7）在治疗过程中 B 组出现男性乳房发育1例。结论4种治疗方案均可降低伴肾上腺增生高血压患者血压，但硝苯地平控释片30 mg ＋厄贝沙坦片150 mg＋螺内酯20 mg 方案优于其它降压方案。
목적：탐토불동치료방안치료반신상선증생고혈압적림상료효。방법장반신상선증생고혈압환자수궤분위4조：A 조：초분지평공석편30 mg ＋라내지20 mg （n ＝30），B 조：초분지평공석편30 mg ＋라내지40 mg （n ＝31），C 조：초분지평공석편30 mg ＋액패사탄편150 mg ＋라내지20 mg （n ＝29），D 조：초분지평공석편30 mg ＋액패사탄편150 mg ＋안위제（n ＝29），출원후수방제1、2、3、4주급제2、3、6、9、12개월혈압급전해질。평고각조치료전후혈압、전해질수평。결과（1）치료12개월후4조수축압하강폭도분별위13．4％、14．1％、18．0％、16．9％；서장압하강폭도분별위17．5％、17．8％、24．7％、22．9％。（2）치료제1、2、6、9、12개월 C 조수축압저우기타각조，차이유통계학의의。（3）치료제1、9、12개월 C 조서장압저우기타각조，차이유통계학의의。（4）치료후제6、9개월 B 조혈갑고우기타조，제12개월 B 조、C 조혈갑고우기타조，차이유통계학의의。（5）A 조현효솔、유효솔、무효솔분별위66．7％、26．7％、6．6％，B 조위80．6％、16．1％、3．3％，C 조위86．2％、10．3％，3．5％，D 조위82．8％、13．8％、3．4％。（6）4조환자치료전후혈갑여혈압균정부상관。（7）재치료과정중 B 조출현남성유방발육1례。결론4충치료방안균가강저반신상선증생고혈압환자혈압，단초분지평공석편30 mg ＋액패사탄편150 mg＋라내지20 mg 방안우우기타강압방안。
Objective To explore the different treatment options for hypertension with adrenal hyperplasia clinical perspective effect .Methods The patients with adrenal hyperplasia of hypertension were randomly divided into four groups :group A :nifedipine controlled release tablets 30 mg + spironolactone 20 mg (n =30) ;group B :nifedipine controlled release tablets 30 mg + spironolactone 40 mg (n = 31) ,group C :nife‐dipine controlled release tablets 30 mg + Irbesartan Tablets 150 mg + spironolactone 20 mg (n = 29) , group D :nifedipine controlled release tablets 30 mg + Irbesartan Tablets 150 mg + placebo (n = 29) ,After discharge follow‐up of 1 ,2 ,3 ,4 weeks and 2 ,3 ,6 ,9 and 12 months of blood pressure and electrolyte . Assessed among groups before and after treatment of blood pressure ,electrolyte levels .Results (1) 12 months after treatment of 4 set of systolic blood pressure decreased ,respectively :13 .4% ,14 .1% ,18 .0% , 16 .9% ;Diastolic blood pressure decreased ,respectively :17 .5% ,17 .8% ,24 .7% ,22 .9% .(2) 1 ,2 ,6 ,9 and 12 months of systolic blood pressure is lower than other groups ,group C was statistically significant . (3) 1 ,9 ,12 months of diastolic down from other groups ,group C was statistically significant .(4) 6 ,9 months in group B after treatment of potassium is higher than other groups ,12 months in group B ,group C of potassium is higher than the other group ,with statistical significance .(5) Group A significant effec‐tive ,efficient ,inefficient were 66 .7% ,26 .7% ,6 .6% ,group B was 80 .6% ,16 .1% ,3 .3% ,group C was 86 .2% ,10 .3% ,3 .5% ,group D was 82 .8% ,13 .8% ,3 .4% .(6) four groups before and after treatment in patients with potassium and blood pressure were negatively correlated .(7) An gynecomastia appears in group B during treatment .Conclusion Four kinds of treatment programs can reduce blood pressure in pa‐tients with adrenal hyperplasia of hypertension ,but nifedipine controlled release tablets 30 mg + Irbesartan Tablets 150 mg + spironolactone 20 mg program is superior to other antihypertensive programs .