氯沙坦治疗老年轻、中度高血压病的临床观察

CLINICAL STUDY OF LOSARTAN IN THE TREATMENT OF MILD AND MODERATE ELDERLY ESSENTIAL HYPERTENSION

目的 探讨氯沙坦对老年轻、中度高血压病的临床疗效、安全性和不良反应。方法 氯沙坦 50mg/d口服 ,服药 2周后坐位舒张压≥ 1 1 .9kPa者加用双氢克尿塞 1 2 .5mg/d ,疗程共 8周。观察偶测血压和心率 ,用药前后动态血压监测 ,检验血、尿常规、肝肾功能、血糖、血脂、电解质、心电图等。结果 实际观察 54例 ,单独使用氯沙坦的 46例患者疗程结束后显效 2 1例 (45 .65 % ) ,有效 2 5例 (54 .35 % )。 8例合用双氢克尿塞 1 2 .5mg/d ,疗程结束后显效 7例 ,有效 1例。分析 32例治疗前后均作了 2 4h动态血压监测的患者 ,治疗后 2 4h动态血压监测各项血压值较治疗前显著下降 (P <0 .0 1 ) ,治疗后 2 4h平均心率 ,昼与夜间心率较治疗前均无明显变化(P >0 .0 5)。不良反应轻微。结论 氯沙坦治疗中老年轻、中度原发性高血压疗效确切、耐受性佳 ,与双氢克尿塞合用安全 ,并能增加疗效 ,可作为治疗高血压的一线选择药物之一。

Objective To investigate the clinical effecacy, safety and the side effect of losartan in the elderly patients with mild and moderate essential hypertension.Methods 54 cases were given 50mg of losartan once daily. Those , whose diastolic blood pressure showed above 11,9kpa after 2 weeks' treatment, were given additional 12.5mg of DHCT once daily. The treatment course was 8 weeks. Ambulatory blood pressure monitoring (ABPM) and casual blood pressure, hepatic and renal function, blood glucose, and plasma electrolyte were all examined before and after the treatment.Results Among the 46 cases receiving losartan, 21 showed remarkable effect and 25 were responded properly, and among 8 cases receiving losartan and DHCT, 7 showed remarkable effect and 1 was properly responded.. 32 cases received ABPM and the blood parameters of 24h monitoring were significantly decreased compared with pre-treatment (P<0.01). There was no difference in HR change. The adverse reactions to losartan were mild.Conclusion Losartan and losartan combined with HDCT is a safe and reliable antihypertension drug. It is recommended as one of the routine therapies in the treatment of mild and moderate essential hypertension.