苯磺酸氨氯地平联合缬沙坦治疗高血压患者的临床观察

Clinical Observation of Amlodipine Besylate Combined with Valsartan in the Treatment of Hypertension

目的:观察苯磺酸氨氯地平联合缬沙坦治疗高血压患者的疗效及安全性。方法:选取住院治疗的高血压患者158例,按随机数字表法分为治疗组(80例)和对照组(78例)。对照组患者采用苯磺酸氨氯地平治疗,2.5 mg/次,3次/d;治疗组患者在对照组基础上加服缬沙坦,80 mg/次,1次/d。4周为1个疗程,均观察5个疗程。比较两组患者的临床疗效、血压、不良反应发生率及血浆内皮素(ET)-1、N末端B型钠尿肽原(NT-pro BNP)、血管紧张素Ⅱ(AngⅡ)浓度。结果:治疗组患者治疗4、8、12、16、20周后血压达标率显著高于对照组,差异有统计学意义(P<0.05);与对照组比较,治疗组患者治疗4、8、12周后收缩压(SBP)、舒张压(DBP)水平均显著降低,差异有统计学意义(P<0.05);两组患者治疗20周后血清ET-1、NT-pro BNP及AngⅡ水平显著降低且治疗组患者降低更加显著,差异有统计学意义(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:氨氯地平联合缬沙坦可以有效控制高血压患者血压水平,疗效较好,可能是通过抑制患者血浆ET-1、NT-pro BNP及AngⅡ水平发挥作用。

OBJECTIVE：To observe therapeutic efficacy and safety of amlodipine besylate combined with valsartan in the treatment of hypertension. METHODS：158 patients with hypertension were randomly divided into control group（n=78） and treatment group（n=80）. Control group was treated with amlodipine besylate,2.5 mg/time,3 times/d;treatment group was additionally treated with valsartan,80 mg/time,once a day. A treatment course lasted for 4 weeks,and both received 5 courses. Clinical efficacy,blood pressure,plasma concentrations of ET-1,NT-pro BNP and Ang Ⅱ were compared between 2 groups. RESULTS： The compliance rates of treatment group after 4,8,12,16,20 weeks were higher than that of the control group（P〈0.05）.Compared with control group,SBP and DBP of treatment group were decreased significantly after 4,8,12 and 20 weeks,with statistical significance（P〈0.05）. After 20 weeks,the serum levels of ET-1,NT-pro BNP and Ang Ⅱwere decreased significantly,especially treatment group,with statistical significance（P〈0.05）. There was no statistical significance in the incidence of ADR between 2 groups（P〈0.05）. CONCLUSIONS：Amlodipine besylate combined with valsartan can effectively control the blood pressure in patients with hypertension,which may be related to the inhibition of ET-1,NT-pro BNP and AngⅡ.