氨氯地平和卡托普利联合治疗顽固性高血压的临床疗效观察

Combination of Amlodipine and Captopril Treatment in Resistant Systemic Hypertension

观察氨氯地平与卡托普利对顽固性高血压的联合治疗作用。方法高血压Ⅱ～Ⅲ期病人４２人，入选前停药两周，经卡托普利１２．５ｍｇ３／ｄ，２周后ＤＢＰ＞９５ｍｍＨｇ者随机分成２组，分别加服氨氯地平和安慰剂，４周为一个疗程。结果在卡托普利基础上加服氨氯地平使平均ＳＢＰ从１７４降至１４８ｍｍＨｇ。平均ＤＢＰ从１０５降至９２ｍｍＨｇ（Ｐ＜０．００１），安慰剂纠正的氨氯地平降压作用ＳＢＰ降低２２ｍｍＨｇ，ＤＢＰ降低１２ｍｍＨｇ（Ｐ＜０．０１）。结论氨氯地平与卡托普利合用可用于治疗顽固性高血压。

Aim\ To explore the therapeutic usage of combining amlodipine and captopril in treatment of hypertension.\ Methods\ Forty two patients had hypertension of WHO stage Ⅱ￣Ⅲ,with mean DBP>95 mmHg after antihypertensive therapy of single captopril 125 mg 3/d for 2 weeks.\ Then patients were randomized into combined amlodipine group and captopril group or contnuating single captopril for another 4 weeks.\ Results\ Amlodipine combined with captopril was shown to be effective than single captopril group.\ The mean SBP decreased from 174 to 148 mmHg and mean DBP from 105 to 92 mmHg(P<001).\ After adjustmnet of the effect by single captopril, the reduction magnitute of BP in combined amlodipine and captopril group was 22/12 mmHg.\ The adverse effect of combination treatment was fewer and milder than that in single captopril group.\ Conclusion\ The combination of amlodipine and captopril was effective to patients who were refractory to single captopril treatment.