厄贝沙坦对高龄患者的降压疗效及靶器官保护作用

The antihypertensive effect of irbesartan and its protection on target organ in senile patients with hypertension

目的通过24h动态血压监测(ABPM),比较厄贝沙坦与依那普利对高龄高血压患者的降压疗效及靶器官保护。方法将94例高龄(年龄≥75岁)原发性高血压患者,随机分为厄贝沙坦组47例与依那普利组47例,两组疗程均为8周。比较两组治疗前后采用24hABPM前后降压疗效及血尿酸等指标变化。结果厄贝沙坦组总有效率为91.49%,依那普利组为89.36%,两组相比无统计学差异(P>0.05);两组治疗后24hSBP、24hDBP、dSBP、dDBP、nSBP、nDBP均显著降低(P<0.01);两组降压的谷/峰比值分别为(80.65±5.3)%和(47.90±4.6)%,有显著性差异(P<0.01);两组治疗后非杓型高血压所占比例相比有统计学差异(P<0.01);厄贝沙坦组治疗前后血尿酸有统计学差异(P<0.01),依那普利组治疗前后无统计学差异(P>0.05)。结论厄贝沙坦对高龄高血压患者降压疗效确切,并能明显改善患者血压昼夜节律,明显降低血尿酸水平,不良反应发生少而轻,依从性和耐受性良好,可以作为高龄高血压患者的首选药物之一。

Objective To compare the antihypertensive effects and their protection on target organ of irbesartan, and enalapril in senile patients with hypertension by 24-hour ambulatory blood pressure monitoring （ABPM）. Method The 94 senile （≥75 years old）esssntial hypertension patients were randomly divided into two groups：irbesartan group （n=47）and enalapril group （n=47）. The course of treatment was 8 weeks. All the patients were measured 24-hour ambulatory blood pressure by Space-labs90207 ambulatory blood pressure check instrument （made by American） before and after treatment,simutaneously serum uric acid and other factors were measured. Result The total effective rate of irbesartan group and enalapril group was 91.49% and 89.36%,respectively,there was no significantly difference between two groups（P〉0.05）. The 24hSBP,24hDBP,dSBP,dDBP,nSBP,nDBP of two groups were significantly decreased before and after treatment （P〈0.01）. The T/P ratio of two groups was （80.65± 5.3）% and （47.9±4.6）% respectively,there was significantly difference（P〈0.01）. In rate of non-dipper hypertension after treatment between two groups there was significantly difference （P〈0.01）. In serum uric acid level of irbesartan group there was significantly difference before and after treatment （P 〈0.01） , and no significantly difference（P〉0.05 ） in enalapril group. Conclusion Irbesartan is effective to decrease of blood pressure in senile patients with hypertension,can markedly improve the circadian rhythm of blood pressure,significantly decrease the serum uric acid level,has less and slight adverse reaction,has a well compliance and tolerability,and can be one of the first drugs to be seclected in senile patients with hypertension.