小剂量氨氯地平联合厄贝沙坦治疗老年高血压的疗效和安全性

Efficacy and safety of low dose amlodipine combined with irbesartan in the treatment of elderly hypertension

目的评价小剂量氨氯地平(络活喜)联合厄贝沙坦(安博维)治疗老年高血压的降压疗效和安全性。方法选择我院2017年1月至2018年12月期间收治的60例老年高血压患者,按随机数字表法分为对照组(安博维0.15g、每日1次)和联合组(安博维0.15g、每日1次+络活喜2.5mg、每日1次),每组30例。治疗2个月后将两组患者的临床疗效、用药前后收缩压(SBP)和舒张压(DBP)水平以及药物不良反应(ADR)发生率进行对比。结果对照组总有效率70.0%,显效10例(33.33%),有效11例(36.67%),无效9例(30.0%);联合组总有效率93.33%,显效18例(60.0%),有效10例(33.33%),无效2例(6.67%);对照组的总有效率低于联合组,两组疗效比较差异有统计学意义(Z=-2.470,P=0.014)。对照组及联合组用药后SBP和DBP与用药前比较均有明显改善,联合组用药后改善幅度明显大于对照组,组内用药前后及组间比较差异均有统计学意义(P<0.05)。对照组出现轻微头痛3例,轻度眩晕3例,疲乏感4例,ADR发生率为33.33%(10/30例),联合组出现轻微头痛1例,轻度眩晕1例,疲乏感1例,ADR发生率为10.0%(3/30例),对照组ADR发生率高于联合组,两组比较差异有统计学意义(χ2=4.812,P=0.028)。结论小剂量络活喜联合安博维治疗老年高血压临床效果显著,降压效果较好,用药安全性较高。

Objective To evaluate the efficacy and safety of low dose amlodipine(Norvasc)combined with irbesartan(Aprovel)in the treatment of elderly hypertension.Methods 60 elderly patients with hypertension admitted to our hospital from January 2017 to December 2018 were selected and divided into the control group(Aprovel 0.15 g,qd)and the combination group(Aprovel 0.15 g,qd+Norvasc 2.5 mg,qd)according to the random number table method,with 30 cases in each group.After 2 months of treatment,the clinical efficacy,systolic blood pressure(SBP)and diastolic blood pressure(DBP)levels before and after medication and the incidence of adverse drug reactions(ADR)were compared between the two groups.Results The total effective rate of the control group was 70.0%(21/30 cases),and that of the combined group was 93.33%(28/30 cases).The difference in efficacy between the two groups was statistically significant(P<0.05).SBP and DBP levels in the control group and the combined group were significantly improved compared with those before and after administration,and the improvement range was significantly greater in the combined group than in the control group,with statistically significant differences before and after administration and between groups(P<0.05).The incidence of ADR in the control group and the combination group was 33.33%(10/30 cases)and 10.0%(3/30 cases),respectively,and the difference between the two groups was statistically significant(P<0.05).Conclusion Low dose Norvasc combined with Aprovel in the treatment of elderly hypertension has significant clinical effect,good antihypertensive effect and high drug safety.