血管紧张素转化酶抑制剂加钙离子拮抗剂联合用药治疗模式对于轻、中度原发性高血压的临床疗效观察及其对血尿酸水平的影响

Clinical investigation of ACE inhibitor combined with calcium antagonist on the patients with mild to moderate essential hypertension and it's effect on the serum uric acid level

目的:比较卡托普利与氨氯地平联合用药与氨氯地平单独使用对于轻、中度原发性高血压患者的血压的调控及其血尿酸水平的影响。方法:选取本院门诊轻、中度原发性高血压患者80例进行随机、双盲的临床研究,所有患者经过2周清洗期后随机分为两组,其中联合用药组40例,采用卡托普利25 mg/次,每天2次,加氨氯地平5 mg/d处理;钙拮抗剂组40例,采用氨氯地平5 mg/d处理,为期8周。对比观察治疗前后血压变化情况。采用全自动生化分析仪检测治疗前后患者空腹血尿酸的变化情况。结果:联合用药组治疗4周后,平均坐位舒张压由治疗前的(98±7)mm Hg(1 mm Hg=0.133 kPa)下降至(92±8)mm Hg;治疗8周后,平均坐位舒张压为(86±11)mm Hg,治疗后较治疗前显著降低(P<0.05)。钙拮抗剂组,治疗前平均坐位舒张压为(96±8)mm Hg,治疗4周后,平均坐位舒张压为(95±7)mm Hg,与治疗前比较无统计学差异(P>0.05);治疗8周后,平均坐位舒张压为(90±8)mm Hg,较治疗前显著降低(P<0.05)。治疗8周后,两组间平均坐位舒张压下降幅度比较,联合用药组降低更为显著(P<0.05)。联合治疗与钙拮抗剂都能降低患者的血尿酸水平,联合用药组降低程度明显高于钙拮抗剂组(P<0.05)。结论:早期联合用药治疗轻、中度高血压患者,能够很好地控制轻、中度高血压,同时能够更好地发挥对重要脏器的保护作用。

AIM： To compare the clinical effeet of combination of captopri with amlodipine and monotherapy of amlodipine, and the influ-ence on the serum uric acid level. METHODS： 80 patients with mild to moderate essential hy-pertension were selected and divided into two groups. 40 treated with amlodipine （tients of the patients of the study group were captopri （25mg/capsule, bid） and 5 mg, q. d.） for 8 weeks, 40 pa control group were treated with am-lodipin （5mg, q. d. ） for 8 weeks. The efficacy of both groups was evaluated by comparing the variance of blood pressure and serum uric acid. RESULTS： The blood pressure of the combined therapy was decreased from （98±7） mm Hg to （92±8） mm Hg after 4 weeks and to （86±11） mm Hg after 8 weeks, the difference is statisti- cally significant （P〈0.05）. The blood pressure of the monotherapy group was （96±8） mm Hg, which is not statistically significant different from （95±7） mm Hg after 4 weeks. The blood pressure of the monotherapy group was （90±8） mmHg after 8 weeks, which is significantly dif-ferent from （96±8） mm Hg （P〈0.05）. The decreased extent of the combined therapy group was significantly different from the monotherapy group. The serum uric acid of the two groups were decreased and the decreased extent of the combined therapy was significant than that of monotherapy group. CONCLUSION. The corn bined therapy for the mild to moderate essential hypertension is an effective strategy and can pro-tect the organ.