不同剂量缬沙坦联合氨氯地平治疗老年高血压的临床效果评价

Clinical evaluation of the effects of different doses of Valsartan combined with Amlodipine in treating senile hypertension

目的 研究不同剂量缬沙坦联合氨氯地平治疗老年高血压的临床效果.方法 将2011年1月～2012年12月临安市人民医院收治的160例老年高血压患者纳入研究,随机分为给予不同剂量缬沙坦联合氨氯地平治疗的观察组和对照组,分别于治疗前和治疗后3个月时检测血压情况、肾功能情况,并分析血压与肾功能的相关性.结果 ①治疗后,观察组与对照组患者的24 h平均收缩压（24 h SBP）[（121.8±15.9）mmHg比（122.6±14.7）mmHg,t=1.038,P＞0.05,1 mm Hg=0.133 kPa]、24 h平均舒张压（24 h DBP）[（72.8±9.8）mm Hg比（73.1±13.1）mm Hg,t=0.938、P＞0.05]差异无统计学意义,24 h平均收缩压变异度（24 h SBPV）[（8.4±1.4）mm Hg比（13.8±1.9）mm Hg,t=6.832,P＜0.05]、24 h平均舒张压变异度（24 h DBPV）[（6.9±1.9）mm Hg比（10.8±2.4）mmHg,t=6.384,P＜0.05]均低于对照组;②治疗后,观察组患者的血肌酐[（82.8±11.3）μmol/L比（121.8±15.3）μmol/L,t=5.893,P＜0.05]、血尿素氮[（4.3±0.9）mmol/L比（6.5±0.8）mmol/L,t=5.374,P＜0.05]、24 h尿蛋白[（0.23±0.03）g比（0.48±0.06）g,t=6.842,P＜ 0.05]水平均低于对照组,内生肌酐清除率[（99.5±14.5）mL/min比（89.5±13.8）mL/min,t=4.982,P＜ 0.05]高于对照组;③收缩压和舒张压水平均与血肌酐、血尿素氮、24 h尿蛋白水水平呈正相关关系,与内生肌酐清除率呈负相关关系.结论 加倍剂量缬沙坦联合氨氯地平治疗有助于减小血压昼夜变异度,改善肾功能状况,对于老年高血压的治疗具有积极价值.

Objective To study the clinical effects of different doses of Valsartan combined with Amlodipine in treating senile hypertension.Methods 160 cases of senile hypertension patients in Lin＇an People＇s Hospital from January 2011 to December 2012 were enrolled and randomly divided into observation group and control group treated with different doses of Valsartan and Amlodipine.Then blood pressure,renal function were detected before treatment and 3 months after treatment,correlation between blood pressure and renal function were analyzed.Results ①After treatment,24 h SBP [（121.8±15.9） mm Hg vs （122.6±1.4.7） mm Hg,t =1.038,P ＞ 0.05,1 mm Hg=0.133 kPa],24 h DBP [（72.8±9.8） mm Hg vs （73.1±13.1） mm Hg,t =0.938,P ＞ 0.05] of observation group had no significant differences compared with control group,and 24 h SBPV [（8.4±1.4） mm Hg vs （13.8±1.9） mm Hg,t =6.832,P＜ 0.05],24 h DBPV [（6.9±1.9） mm Hg vs （10.8±2.4） mm Hg,t =6.384,P ＜ 0.05] of observation group were lower than those of control group; ②Scr [（82.8±11.3） μmol/L vs （121.8± 15.3） μmol/L,t =5.893,P ＜ 0.05],BUN [（4.3±0.9） μmol/L vs （6.5±0.8） μmol/L,t =5.374,P ＜ 0.05],24 h urinary protein [（0.23±0.03） g vs （0.48±0.06） g,t =6.842,P ＜ 0.05] of observation group were lower than those of control group; Ccr [（99.5±14.5） mL/min vs （89.5±13.8） mL/min,t =4.982,P ＜ 0.05] was higher than that of control group; ③the SBP and DBP were positively correlated with Scr,BUN,24 h urinary protein and negatively correlated with Ccr.Conclusion The treatment of double doses of Valsartan combined with Amlodipine has positive value in treating senile hyperten sion,and it is helpful to reduce blood pressure variability and improve renal function.