氨氯地平为基础的不同用药方案治疗原发性高血压的疗效观察

目的:探讨氨氯地平联合复方阿米洛利或替米沙坦治疗原发性高血压的临床疗效和安全性.方法:采用随机开放对照盲终点评估的方法,入选原发性高血压患者180例,随机分为氨氯地平+复方阿米洛利(阿米洛利组)和氨氯地平+替米沙坦组(替米沙坦组),均服药12周,观察血压、降压达标率、有效率、不良反应,检测脉搏波速度(Pulse wave velocitv PWV)、生化指标结果:治疗12周后,阿米洛利组和替米沙坦组之间收缩压和舒张压下降幅度差异无统计学意义(P＞0.05).两组降压达标率、有效率和不良反应率之间差异无统计学意义(P＞0.05).治疗前后两组患者双侧PWV均明显下降(P＜0.05).治疗后替米沙坦组尿酸水平明显下降(P＜0.05).结论:氨氯地平联合复方阿米洛利或替米沙坦均能显著降低原发性高血压患者血压,耐受性好,不良反应少.两组均能有效改善患者动脉僵硬程度,替米沙坦组能更好的降低患者尿酸水平.

Efficacy and safety of combination regimens based on amlodipine in treating essential hypertension

Objective：To evaluate the efficacy and safety of two combination regimens based on amlodipine in the treatment of essential hypertension.Methods：The randomized,controlled,opened,blind-endpoint assessment clinical trial was carried out in essential hypertensive patients.180 patients with blood pressure≥140/90 mmHg （1 mmHg=0.133 kPa）were assigned to one of the two treatment groups：amlodipine plus amiloride compound group （amiloride group,n=87）,amlodipine plus telmisartan group （telmisartan group,n=93）.Antihypertensive efficacy,safety,adverse reactions,PWV,ABI and biochemical indicators were evaluated in the period of 12 weeks.Results： After 12 weeks’combination treatment,the SBP/DBP were reduced by （29.8±10.9）mmHg/（13.2±6.8）mmHg,（26.2±9.6）mmHg/ （15.0±6.6）mmHg in amiloride group and telmisartan group respectively,there was no significant difference between the two groups （P 0.05）.The rate of reaching standard was 68.7% in amiloride group,69.2% in telmisartan group,respectively with the effective rate of 90.1% and 87.9%（P0.05）.The total side effects were similar and mild in two groups.There was significant difference in PWV between patients with pretherapy and posttherapy both in two groups（P0.05）.The decrease in the level of uric acid was significantly in telmisartan group （P0.05）.Conclusion：Amlodipin associated with amiloride or telmisartan can reduce significantly the blood pressure of elderly hypertensive patients,with safety,good tolerance.Both of two groups can improve the elasticity of arterial.In combination with telmisartan,the level of uric acid decreases obviously.