CAJ | 학술논문

目的探讨盐敏感性高血压和非盐敏感性高血压对靶器官损害及联合药物治疗的差异.方法选取120例轻中度高血压住院患者,经盐负荷试验测试,60例定为盐敏感性高血压组(SS),另选择60例为非盐敏感性高血压组(NSS),将此两组再分别随机分为两小组,每组30例,分别给予非洛地平片联合培哚普利片以及吲达帕胺缓释片联合培哚普利片治疗12周,测量治疗前后24 h动态血压、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、左室重量指数(LVMI)、尿微量白蛋白(MAU)、BMI、血清肌酐(Cr)、血清尿酸(UA)的变化.结果 SS组与NSS组相比,FPG和Cr水平的差异有统计学意义(P＜0.01),FINS、LVMI、MAU、BMI、HOMA-IR的差异亦有统计学意义(P＜0.05)；SS组中使用培哚普利联合吲达帕胺治疗的患者,各项相关检测指标更趋于正常范围,差异有统计学意义(P＜0.05)；NSS组中使用培哚普利联合非洛地平治疗的患者,其各项检测指标更趋于正常范围,差异有统计学意义(P＜0.05).结论盐敏感性高血压患者的靶器官损害更明显,适于培哚普利与吲达帕胺联合药物治疗,而非盐敏感性患者适于培哚普利与非洛地平联合治疗.
목적 탐토염민감성고혈압화비염민감성고혈압대파기관손해급연합약물치료적차이.방법 선취120례경중도고혈압주원환자,경염부하시험측시,60례정위염민감성고혈압조(SS),령선택60례위비염민감성고혈압조(NSS),장차량조재분별수궤분위량소조,매조30례,분별급여비락지평편연합배타보리편이급신체파알완석편연합배타보리편치료12주,측량치료전후24 h동태혈압、공복혈당(FPG)、공복이도소(FINS)、이도소저항지수(HOMA-IR)、좌실중량지수(LVMI)、뇨미량백단백(MAU)、BMI、혈청기항(Cr)、혈청뇨산(UA)적변화.결과 SS조여NSS조상비,FPG화Cr수평적차이유통계학의의(P＜0.01),FINS、LVMI、MAU、BMI、HOMA-IR적차이역유통계학의의(P＜0.05)；SS조중사용배타보리연합신체파알치료적환자,각항상관검측지표경추우정상범위,차이유통계학의의(P＜0.05)；NSS조중사용배타보리연합비락지평치료적환자,기각항검측지표경추우정상범위,차이유통계학의의(P＜0.05).결론 염민감성고혈압환자적파기관손해경명현,괄우배타보리여신체파알연합약물치료,이비염민감성환자괄우배타보리여비락지평연합치료.
Objective To study the damage on organs from salt sensitivity hypertension or non-salt-sensitive hypertension and the selection of drug combination.Methods 120 hypertensive patiems including 60 cases salt-sensitive (SS) and 60 non-salt-sensitive (NSS) groups were selected in our hospital and their salt load tested.These two groups were randomly divided into two groups,each group with 30 patients,one was given felodipine and perindopril and the others were given indapamide sustained release tablets and peridopril to facilitate the 12-week treatment.Before and after the treatment,patients were tested for physiological indicators,such as sitting blood pressure,24-hour ambulatory blood pressure,insulin resistance index,comparing changes of various sub-index etc.Results Significantly different were seen in indices as fasting blood glucose and serum creatinine (P＜ 0.01),fasting insulin,left ventricular mass index,urinary albumin,body mass index,insulin resistance indices,while between the SS group and the NSS group(P＜0.05).In the SS group,when patients with various sub-indicators were using perindopril combined with indapamide treatment,the related detected indicators tended to be normal and with statistically significant differences (P＜0.05).In the NSS group,those related indexes also tended to be more normal when using felodipine combined with perindopril.However,there were statistically significant differences between the two groups (P＜0.05).Conclusion On SS hypertensive patients with target organ damages,perindopril and indapamide seemed to be more effective in NSS patients,indicating that the use of perindopril and felodipine combination,seemed to be more suitable.