螺内酯治疗难治性高血压23例疗效观察

Efficacy of spironolactone in the treatment of resistant hypertension

目的观察螺内酯治疗难治性高血压的疗效。方法把45例门诊难治性高血压患者随机分成治疗组23例和对照组22例,对照组接受改善生活方式和包括利尿剂在内的抗高血压药物的基础治疗,治疗组在基础治疗的同时加用螺内酯(醛固酮拮抗剂)20mg,每天一次,测量治疗前、治疗3周后所有患者血压及检测治疗组治疗前后血钾水平。结果治疗组收缩压、舒张压治疗3周后与治疗前比较,差异有统计学意义,P<0.05,治疗组治疗前后血钾均在正常范围内。结论在定期检测血钾的情况下,难治性高血压患者在利尿剂、钙离子拮抗剂和血管紧张素转换酶抑制剂基础上加用小剂量螺内酯可取得满意的降压效果。

Objective To observe the effect of spironolactone on resistant hypertension.Methods 45 out-patients with resistant hypertension were randomly divided into two groups：treatment group（n=23） and control group（n=22）.The cases in control group received antihypertensive drugs including diuretics and improved the lifestyle,while the others continued the basic treatment plus spironolactone（aldosterone antagonist）20mg once a day.All patients,blood pressure and the plasma potassium of patients in treatment group were respectively measured pre-treatment and after 3 weeks treatment.Results After 3 weeks treatment,the systole blood pressure and diastole blood pressure were significantly different from pre-treatment in treatment group（P0.05）,meanwhile the levels of serum potassium were in the normal range in treatment group before and after treatment.Conclusion In regular inspection of plasma potassium,the patients with resistant hypertension can take satisfactory antihypertensive effect by adding low dose spironolactone based on diuretics calcium channel blockers（CCB） and angiotensin-converting enzyme inhibitors（ACEI）.