螺内酯治疗老年高血压的临床疗效及对血清炎性因子水平的影响

Efficacy of Spironolactone in the Treatment of Elderly Patients with Hypertension and Its Effect on the Serum Levels of Inflammatory Factors

目的:探讨螺内酯治疗老年高血压的临床疗效及对血清炎性因子水平的影响。方法:选择2017年6月至2018年12月我院收治的144例老年高血压患者,根据治疗方法的不同将其分为观察组80例与对照组64例。对照组给予硝苯地平治疗,观察组给予螺内酯治疗,两组均治疗观察4周,对比两组治疗前后的血清内皮素(Endothelin,ET)-1和血栓素(Thromboxane,TX)-B2含量、白介素(Interleukin,IL)-6与可溶性细胞间粘附分子(Soluble intercellular adhesion molecule,s ICAM-1)水平的变化及临床疗效。结果:所有患者完成治疗,无严重不良反应发生。治疗后,观察组的总有效率为98.8%,显著高于对照组(85.9%,P<0.05)。两组治疗后24 h收缩压(Systolic blood pressure,SBP)和舒张压(Diastolic bloodpressure,DBP)、血清ET-1、TX-B2、IL-6与s ICAM-1水平均显著低于治疗前(P<0.05),且观察组以上指标均明显低于对照组(P<0.05)。结论:螺内酯治疗老年高血压的临床疗效明显优于硝苯地平治疗,可能与其明显抑制血清与ET-1、TX-B2、IL-6与s ICAM-1水平有关。

Objective:To investigate the clinical efficacy of spironolactone in the treatment of elderly patients with hypertension and its effect on the levels of serum inflammatory factors.Methods:From June 2017 to December 2018,144 cases of elderly patients with hypertension were selected and divided into the observation group(80 cases)and control group(64 cases)according to different treatment methods.The control group was treated with nifedipine,and the observation group was treated with spironolactone.Both groups were treated for 4 weeks,and the levels of serum endothelin(ET)-1 and thromboxane(TX)-B2 levels,interleukin(IL)-6 and Soluble Intercellular Adhesion Molecules(SICAM)before and after treatment and clinical efficacy were compared bwteen two groups.Results:All patients completed treatment without serious adverse reactions.After treatment,the total effective rate of observation group after treatment were significantly higher than that of the control group(98.8%vs.85.9%,P<0.05).The 24 h systolic blood pressure(SBP)or diastolic blood pressure(DBP),serum ET-1,TX-B2,IL-6 and s ICAM-1 levels in the two groups were significantly lower than those before treatment(P<0.05),and the above indicators in the observation group were significantly lower than the control group(P<0.05).Conclusion:The clinical efficacy of spironolactone in the treatment of elderly hypertension is significantly better than that of nifedipine,which may be related to the significant inhibition of serum and ET-1,TX-B2,IL-6 and s ICAM-1 levels.