小剂量螺内酯在老年难治性高血压患者中的疗效及安全性分析

Efficacy and Safety of Low-dose Spironolactone in Elderly Patients With Refractory Hypertension

目的:评价小剂量螺内酯在老年难治性高血压患者中的有效性及安全性。方法:选取2015年5月至2015年12月于我院心内科门诊就诊的RH患者85例,其中男性45例,女性40例,年龄72.12±6.34岁。随机分为实验组及对照组。两组在A+C+D治疗方案的基础上,实验组加用螺内酯20mg/d,对照组服用安慰剂。随访8周,观察患者血压、血钾、血肌酐等指标的变化。结果:实验组因出现2例不良反应,及1例失访,共3例退出试验,对照组1例失访;随访8周后两组患者之间的各项指标进行统计学分析,收缩压、舒张压较前明显下降,差异具有统计学意义P<0.05;钾离子、血肌酐有所增高差异具有统计学意义P<0.05;但尚未超过正常参考值的最高限度。结论:老年难治性高血压患者中在A+C+D治疗方案的基础上,加用小剂量螺内酯可有效降低收缩压及舒张压,且耐受性较好。

Objective： To evaluate the efficacy and safety of low-dose spironolactone in elderly patients with refractory hypertension. Methods： In the hospital,85 patients with RH were enrolled from May 2015 to December 2015,including 45 males and 40 females,aged 72.12 ± 6.34 years. They were randomly divided into test group and control group. On the basis of A ＋ C ＋ D regimen,the patients in the experimental group were treated with spironolactone 20mg/day,the control group was given placebo. Followed up for 8 weeks to observe the changes in blood pressure,serum potassium and serum creatinine. Results： In the experimental group,there were 2 cases of adverse reactions,1 case of lost visit,a total of 3 cases of withdrawal test,the control group 1 case lost. The mean value of systolic blood pressure and diastolic blood pressure decreased significantly after 8 weeks follow-up. The difference was statistically significant（ P〈0.05）; Potassium ion,serum creatinine increased significantly was statistically significant P〈0.05; but not yet exceeded the normal reference value of the maximum. Conclusion： In elderly patients with refractory hypertension in the A ＋ C ＋ D treatment program based on the addition of low-dose spironolactone can effectively reduce systolic and diastolic blood pressure,and tolerance is better.