硝苯地平联合氢氯噻嗪治疗老年高血压的临床观察

Clinical Observation of Nifedipine Combined with Hydrochlorothiazide in the Treatment of Elderly Patients with Hypertension

目的:观察硝苯地平联合氢氯噻嗪治疗老年高血压的疗效和安全性。方法:76例老年高血压患者随机均分为观察组和对照组。所有患者均停止服用其他降压药物3 d后,对照组患者给予硝苯地平缓释片1片,口服,每日2次;观察组患者在对照组治疗的基础上给予氢氯噻嗪片1片,口服,每日1次。两组均以8周为1个疗程,连续治疗2个疗程。观察两组患者的临床疗效,治疗前后平均坐位舒张压(DBP)、平均坐位收缩压(SBP)、肾功能(血钾、血肌酐、尿酸、尿微量白蛋白、尿素氮)及不良反应发生情况。结果:观察组患者总有效率显著高于对照组,不良反应发生率显著低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者平均坐位DBP、平均坐位SBP、肾功能比较,差异均无统计学意义(P>0.05)。治疗后,两组患者平均坐位DBP、平均坐位SBP、血肌酐、尿素氮均显著低于同组治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05);两组患者血钾、尿酸、尿微量白蛋白治疗前后比较,差异均无统计学意义(P>0.05)。结论:硝苯地平联合氢氯噻嗪治疗老年高血压的疗效显著优于单用硝苯地平,可有效降低坐位DBP、坐位SBP,改善肾功能,且安全性较好。

OBJECTIVE：To observe the efficacy and safety of nifedipine combined with hydrochlorothiazide in the treatment of elderly patients with hypertension. METHODS：76 elder patients with hypertension were randomly divided into observation group and control group. After 3 d of antihypertensive drugs withdrawal in all patients,control group was orally treated with one tablet Nifedipine sustained release tablet,twice a day;observation group was additionally given one tablet Hydrochlorothiazide tablet,once a day. 1 course included 8 weeks,and it lasted 2 courses. Clinical efficacy,mean sitting diastolic blood pressure（DBP）,mean sitting systolic blood pressure（SBP）,renal functions（serum potassium,serum creatinine,uric acid,microalbuminuria,blood urea nitrogen）before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS：The total effective rate in observation group was significantly higher than control group,the incidence of adverse reactions was significantly lower than control group,the differences were statistically significant（P〈0.05）. Before treatment,there were no significant differences in the mean sitting DBP,mean sitting SBP and renal functions between 2 groups（P〉0.05）;after treatment,the mean sitting DBP,mean sitting SBP,serum creatinine and blood urea nitrogen in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically significant（P〈0.05）,and there were no significant difference in the serum potassium,uric acid and microalbuminuria before and after treatment（P〉0.05）. CONCLUSIONS：Nifedipine combined with hydrochlorothiazide has significant efficacy in the treatment of senile hypertension,and it can effectively reduce DBP and SBP,and improve renal function indicators,with good safety.