厄贝沙坦/氢氯噻嗪复方片治疗难治性高血压的临床疗效

Irbesartan/hydrochlorothiazide compound table for treating refractory hypertension

目的评价厄贝沙坦/氢氯噻嗪复方片治疗难治性高血压的疗效和不良反应。方法纳入2007年8月至2011年6月空军航空医学研究所附属医院难治性高血压患者96例,随机分为A组[(氨氯地平10mg/d+美托洛尔50mg/d+厄贝沙坦/氢氯噻嗪复方片1片,每片含厄贝沙坦150mg和氢氯噻嗪12.5mg),n=52]和B组(氨氯地平10mg/d+美托洛尔50mg/d+氢氯噻嗪50mg/d,n=44)。分别记录两组治疗前、治疗第2周、第4周和第12周的血压、心率,同时检测治疗前和治疗12周后患者的血钾、血糖、血脂、血肌酐和血尿酸水平,并进行分析。结果与治疗前比较,两组治疗后血压均明显降低(P均<0.05),B组血压下降更迅速,治疗2周后收缩压Avs.B(48.1mmHgvs.136.1mmHg)但A组血压保持稳定的时间较长,治疗12周后有效率更高(Avs.B:75.0%vs.31.9%)。12周后,A组血压达目标水平比率75.0%,低血压发生率5.8%,B组血压达目标水平31.9%,低血压占13.6%。与A组相比,B组血钾降低更明显,血尿酸升高更明显,差异有统计学意义(P<0.05)。结论厄贝沙坦/氢氯噻嗪复方片对难治性高血压患者具有较好的降压效果,且作用平稳,不良反应发生率低。

Objective To review the curative effect and adverse reactions of irbesartan/hydrochlorothiazide compound table for treating refractory hypertension. Methods The patients （n=96） were chosed from Aug. 2007 to Jun. 2011, and randomly divided into group A [treated with amlodipine （10 mg/d） ＋ metoprolol （50 mg/d） ＋ irbesartan （150 mg）/hydrochlorothiazide （12.5 mg） compound table （1 piece）] and group B [treated with amlodipine （10 mg/d） ＋ metoprolol （50 mg/d） ＋ hydrochlorothiazide （50 mg/d）]. The blood pressure （BP） and heart rate （HR） were recorded before treatment and on the 2nd week, 4th week and 12th week after treatment. The levels of serum potassium, plasma glucose, blood fat, serum creatinine （SCr） and blood uric acid （BUA） were detected before and 12 weeks after the treatment. Results BP decreased significantly （P〈0.05） in two groups compared with before treatment, and more significant in group B, the systolic pressure in A and B was 148.1 mmHg, but was stable for longer time in group A, the effetive ratio in group A was higher with 75.0% vs. 31.9%. After 12 weeks, the rate of reaching BP target was 75% in group A and 31.9% in group B, and incidence of hypotension was 5.8% in group A and 13.6% in group B. The decrease of serum potassium and increase of BUA were more significant in group B than those in group A. Conclusion Irbesartan/hydrochlorothiazide compound table has better antihypertensive efficacy with stable effect and less adverse reactions in the patients with refractory hypertension.