国产替米沙坦与苯磺酸左旋氨氯地平联合氢氯噻嗪治疗老年单纯收缩期高血压的疗效及安全性比较

Telmisartan combined with Hydrochlorothiazide and Levamlodipine Besylate combined with Hydrochlorothiazide for isolated systolic hypertension in the elderly

目的比较国产替米沙坦联合氢氯噻嗪(hydrochlorothiazide,HCTZ)与苯磺酸左旋氨氯地平联合HCTZ治疗老年单纯收缩期高血压(isolated systolic hypertension,ISH)的疗效、安全性及耐受性。方法老年ISH患者120例采用随机数字表法分为试验组与对照组各60例。试验组给予替米沙坦40 mg联合HCTZ 12.5 mg口服,qd,降压不达标替米沙坦增加至80mg qd;对照组予苯磺酸左旋氨氯地平片2.5 mg联合HCTZ 12.5 mg口服,qd,降压不达标苯磺酸左旋氨氯地平增加至5 mg,qd,疗程均为14周。结果①显效:试验组40例,对照组24例;有效:试验组20例,对照组24例;无效:试验组6例,对照组12例;达目标血压的例数:试验组54例,对照组48例;总有效率:试验组90%,对照组80%。试验组总有效率高于对照组,差异有统计学意义(P<0.05)。②试验组用药后收缩压、平均动脉压,与用药前比较,差异均有统计学意义(P<0.01),心率用药前后差异无统计学意义(P>0.05);对照组收缩压、平均动脉压、心率与用药前比较,差异均有统计学意义(P<0.01);两组用药后收缩压比较,差异有统计学意义(P<0.05)。③试验组甘油三酯、空腹血糖与治疗前比较,差异有统计学意义(P<0.05),与对照组相比较,甘油三酯、空腹血糖差异有统计学意义(P<0.01),其余生化指标差异无统计学意义(P>0.05)。④对照组不良反应发生率明显高于试验组,差异有统计学意义(P<0.01)。结论 替米沙坦联合HCTZ降压疗效优于苯磺酸左旋氨氯地平联合氢氯噻嗪,并且安全性高,耐受性好。

Objective To compare the efficacy,safety and tolerability of Telmisartan combined with Hydrochlorothiazide（HCTZ） and Levamlodipine Besylate combined with HCTZ for isolated systolic hypertension in the elderly.Methods A total of 120 patients with systolic hypertension were randomly divided into two groups,with 60 cases in each group.The test group was treated with Telmisartan 40 mg q.d combined with HCTZ 12.5 mg q.d.Those with poor antihypertensive efficacy were given another Telmisartan 40 mg q.d.The control group was treated with Levamlodipine Besylate 2.5 mg q.d combined with HCTZ 12.5 mg q.d.Those with poor antihypertensive efficacy were given another Levamlodipine Besylate 2.5 mg q.d.The course of treatment was 14 weeks in both groups.Results Results Markedly effective： test group 40 vs.control group 24;effective： test group 20 vs.control group 24;ineffective： test group 6 vs.control group 12;cases of standard blood pressure： test group 54 vs.control group 48;total effective rate： test group 90% vs.control group 80%,P0.05.In test group,systolic pressure and mean arterial blood pressure reported significant differences after treatment（P0.01）,while heart rate did not（P0.05）.In control group,systolic pressure,mean arterial systolic pressure and heart rate reported significant differences after treatment（P0.01）.Systolic pressure of the two groups reported significant difference（P0.05）.Triglyceride and fasting blood sugar,which was significantly different from those in control group（P0.01）,reported significant differences after treatment compared with those before treatment（P0.05）.Other biochemical indicators reported no statistic significance（P0.05）.Adverse reaction in control group was significantly higher than that in test group（P0.01）.Conclusion The antihypertensive efficacy of Telmisartan combined with HCTZ is better than that of Levamlodipine Besylate combined with HCTZ,which it is safe and well tolerated