容桂地区盐敏感性高血压患者联合药物降压治疗效果的比较

Comparative study on antihypertensive therapy with combined drugs in patients with salt-sensitive hypertension in Ronggui Area

目的研究联合药物降压对控制盐敏感性高血压患者临床指标的影响,以为临床提供参考。方法本研究随机选取我院2014年8月~2016年8月诊断符合标准的中轻度原发性高血压患者(失访率控制在10%内),且根据盐负荷试验确定为盐敏感性高血压的患者60例作为研究对象。根据患者接受的药物治疗方案将其分为a组与b组,各30例,a组给予氨氯地平联合厄贝沙坦治疗,b组给予吲达帕胺联合厄贝沙坦治疗,分别治疗12周,每2周随访一次。对比两组治疗前及治疗12周后患者的血压、肾功能指标及尿微量白蛋白的变化。结果经过12周的治疗,两组收缩压与舒张压均低于治疗前,治疗后b组血压低于a组,差异有统计学意义(P<0.05)。两组治疗后尿素氮(BUN)、血肌酐(SCr)、尿微量白蛋白(mAlb)均较治疗前明显下降,差异有统计学意义(P<0.05);a组治疗后血K+较治疗前明显下降(P<0.05),b组与治疗前比较,差异无统计学意义(P>0.05)。两组治疗后比较,BUN、SCr及mAlb下降均明显高于a组,差异有统计学意义(P<0.05)。结论采用吲达帕胺+厄贝沙坦联合治疗盐敏感性高血压效果更佳,能够改善肾功能状况,维持电解质的稳定,临床效果显著,值得推广。

Objective To study the effect of combined drug hypotension on the clinical indexes of patients with salt- sensitive hypertension,so as to provide reference for clinical practice.Methods Patients with mild to moderate essential hypertension who were selected from August 2014 to August 2016 （with a fall-out rate of 10%）, and were intended to salt sensitive essential hypertensive according to the salt load test,60 patients with essential hypertension were selected as object of study.The patients were divided into group a and group b,30 cases in each groups,according to the patients received drug treament.Patients in group a were given Amlodipine and Irbesartan,patients in group b were treated with Indapamide combined with Irbesartan for treatment,they were treated for 12 weeks,followed up once every 2 weeks.The changes of blood pressure,renal function and urinary microalbumin in patients before and after 12 weeks of treatment were compared.Results After 12 weeks of treatment,systolic and diastolic blood pressure of two groups were lower than before treatment,group b was lower than group a,with significant difference （P〈0.05）.After treatment,serum ereatinine （BUN）,serum creatinine （SCr） and urinary microalbumin （mAlb） of two groups were decreased compared with before treatment,with significant differenees（P〈0.OS）,and the serum K＋ of group a was decreased（P〈0.05）.There was no signifi- cant difference in group b before and after treatment （P〉0.05）.After treatment,BUN,SCr and mAlb in group b were sig- nificantly higher than those in group a which were significant differences （P〈0.05）.Conclusion The combination of In- dapamide and Irbesartan in treatment of salt-sensitive hypertension is better,which can improve the renal function and maintain the stability of electrolyte.The clinical effect is significant.