CAJ | 학술논문

目的：探讨坎地沙坦联合苯磺酸氨氯地平对老年高血压患者血压及相关代谢指标的影响。方法选择2012年6月—2014年12月山东省曲阜师范大学医院收治的老年高血压患者112例，随机分为观察组（ n＝38）、对照A组（n＝37）和对照B组（n＝37）。观察组患者给予坎地沙坦联合苯磺酸氨氯地平治疗，对照A组患者仅给予坎地沙坦治疗，对照B组患者仅给予苯磺酸氨氯地平治疗。比较3组患者治疗前及治疗2、4、6周末坐位血压（收缩压和舒张压）及心率；同时检测治疗前后相关代谢指标，包括空腹血糖（ FBG）、三酰甘油（ TG）、高密度脂蛋白胆固醇（HDL－C）、低密度脂蛋白胆固醇（LDL－C）、血尿酸（UA）、血肌酐（Cr）、丙氨酸氨基转移酶（ALT）及尿素氮（ BUN）等；比较3组患者降压效果并记录治疗期间不良反应发生情况。结果3组患者治疗前和治疗2周末收缩压及治疗前舒张压、心率比较，差异无统计学意义（ P＞0.05）；观察组患者治疗4周、6周末收缩压及治疗2周、4周、6周末舒张压、心率均低于对照A组和对照B组（ P＜0.05）。3组患者治疗前后FBG、 TG、 HDL－C、 LDL－C、 UA、Cr、 ALT及BUN比较，差异均无统计学意义（P＞0.05）。观察组患者降压效果优于对照A组和对照B组（u值分别为17.211、17.327， P＜0.05）。观察组患者不良反应发生率为5.3％，对照A组为8.1％，对照B组为8.1％，差异无统计学意义（P＞0.05）。结论坎地沙坦联合苯磺酸氨氯地平治疗老年高血压疗效确切，能有效降低血压，且对患者代谢无明显影响，安全性较高。
목적：탐토감지사탄연합분광산안록지평대노년고혈압환자혈압급상관대사지표적영향。방법선택2012년6월—2014년12월산동성곡부사범대학의원수치적노년고혈압환자112례，수궤분위관찰조（ n＝38）、대조A조（n＝37）화대조B조（n＝37）。관찰조환자급여감지사탄연합분광산안록지평치료，대조A조환자부급여감지사탄치료，대조B조환자부급여분광산안록지평치료。비교3조환자치료전급치료2、4、6주말좌위혈압（수축압화서장압）급심솔；동시검측치료전후상관대사지표，포괄공복혈당（ FBG）、삼선감유（ TG）、고밀도지단백담고순（HDL－C）、저밀도지단백담고순（LDL－C）、혈뇨산（UA）、혈기항（Cr）、병안산안기전이매（ALT）급뇨소담（ BUN）등；비교3조환자강압효과병기록치료기간불량반응발생정황。결과3조환자치료전화치료2주말수축압급치료전서장압、심솔비교，차이무통계학의의（ P＞0.05）；관찰조환자치료4주、6주말수축압급치료2주、4주、6주말서장압、심솔균저우대조A조화대조B조（ P＜0.05）。3조환자치료전후FBG、 TG、 HDL－C、 LDL－C、 UA、Cr、 ALT급BUN비교，차이균무통계학의의（P＞0.05）。관찰조환자강압효과우우대조A조화대조B조（u치분별위17.211、17.327， P＜0.05）。관찰조환자불량반응발생솔위5.3％，대조A조위8.1％，대조B조위8.1％，차이무통계학의의（P＞0.05）。결론감지사탄연합분광산안록지평치료노년고혈압료효학절，능유효강저혈압，차대환자대사무명현영향，안전성교고。
Objective To investigate the impact of candesartan combined with amlodipine besylate on blood pressure and related metabolic index in senile hypertension patients.Methods A total of 112 senile hypertension patients were selected in the Hospital of Qufu Normal University from June 2012 to December 2014, and they were randomly divided into groups A (n=38), B (n =37), C (n =37).Patients of A group were given candesartan combined with amlodipine besylate, while patients of B group were only given candesartan, patients of C group were only given amlodipine besylate.Sitting blood pressure including SBP and DBP, heart rate were compared among the three groups before treatment and after 2, 4, 6 weeks of treatment; related metabolic index including FBG, TG, HDL-C, LDL-C, UA, Cr, ALT and BUN were detected before and after treatment; antihypertensive effect was compared among the three groups, and incidence of adverse reactions was recorded during the treatment.Results No statistically significant differences of SBP, DBP or heart rate was found among the three groups before treatment, nor of SBP among the three groups after 2 weeks of treatment (P>0.05); SBP of A group was respectively statistically significantly lower than that of B group and C group after 4, 6 weeks of treatment, DBP and heart rate of A group were statistically significantly lower than those of B group and C group after 2, 4, 6 weeks of treatment (P<0.05). No statistically significant differences of FBG, TG, HDL-C, LDL-C, UA, Cr, ALT or BUN was found among the three groups before or after treatment (P>0.05).The antihypertensive effect of A group was statistically significantly better than that of B group and C group, respectively (u=17.211, 17.327, P<0.05).The incidence of A group was 5.3%, that of B group was 8.1%, of C group was 8.1%, the difference was not statistically significantly diffferent ( P >0.05).Conclusion Candesartan combined with amlodipine besylate has certain clinical effect on senile hypertension, which can effectively reduce the blood pressure with high safety, without obvious influence on metabolism.