摘要
目的:探讨血管紧张素转换酶抑制剂(ACEI)雷米普利与血管紧张素受体亚型1拮抗剂(AT1RA)缬沙坦的单用及合用对原发性高血压(EH)的临床疗效及安全性。方法:104例轻中度的EH患者,随机分成3组,雷米普利组(35例)予雷米普利5mg/d,缬沙坦组(35例)予缬沙坦160mg/d,合用组(34例)予雷米普利2.5mg加缬沙坦80mg/d,疗程均为12周。治疗前后测偶测血压、动态血压、肝肾功能、血脂、血糖等,观察不良反应发生情况。结果:雷米普利组总有效率77.1％,降压幅度23.9/15.8mmHg,T/P比值:SBP 0.82、DBP 0.81;缬沙坦组总有效率77.1％,降压幅度24.3/15.1mmHg,T/P比值:SBP 0.83、DBP 0.80;合用组总有效率79.4％,降压幅度24.4/15.2mmHg,T/P比值:SBP 0.83、DBP 0.80,各项指标3组间比较无显著性差异(P均>0.05)。3组药物均可降低血压负荷,其降低值组间比较无显著性差异(P>0.05)。3个用药组治疗前后血常规、生化、血脂、肝肾功能均无明显变化(P均>0.05),总不良反应率组间比较无显著性差异。结论:雷米普利与缬沙坦合用可有效、安全地降压。
Objective: To explore the clinical effects and safety of treating mild to moderate essential hypertension(EH) with combination of ramipril and valsartan. Methods: 104 cases were assigned into three groups randomly, group 1 was treated with ramipril 5mg qd, group 2 was treated with valsartan 160mg qd, group 3 was treated with valsartan 80mg and ramipril 2. 5mg qd for 12 weeks. Causal and ambulatory blood pressure, renal and hepatic function were measured before and after the therapy. Results: The total effective rate, amplitude of blood pressure reduced, T/P ratio of systolic and diastolic blood pressure were 77.1% , 23. 9/15.8mmHg, 0.82 and 0. 81 in ramipril group respectively; were 77.1% , 24.3/15.1mmHg, 0.83 and 0.80 in valsartan group; were 79.4% , 24.4/15.2mmHg, 0.83 and 0.80 in the combination group. The reduction of blood pressure load in three groups were similar. Conclusions: Combination of ramipril and valsartan is safety, and shows a good tolerant profile.
