乐卡地平、比索洛尔和替米沙坦治疗初诊单纯舒张期高血压患者的效果比较

Comparison of the effects of lacidipine,bisoprolol and telmisartan in newly diagnosed patients with isolated diastolic hypertension

目的比较乐卡地平、比索洛尔和替米沙坦治疗初诊单纯舒张期高血压患者的效果。方法选取医院收治的单纯舒张期高血压初诊为患者93例,将其随机平均分为A组、B组、C组,每组31例。A组给予乐卡地平治疗,B组给予比索洛尔治疗,C组给予替米沙坦治疗,治疗期间每周对患者的血压、心率等指标进行随访,治疗1个月对患者心电图、血压、血脂、血糖、肝肾功能等相关指标进行比较。结果治疗后,3组患者舒张压均降低,A组降低(8.2±1.9)mm Hg、B组降低(6.7±2.0)mmHg、C组降低(7.8±1.7)mmHg,A组和C组舒张压降低无显著差异(P>0.05),且降低幅度均好于B组(P<0.05);治疗后,A组心率明显升高(P<0.05),B组降低明显(P<0.05),C组患者心率降低幅度介于A组和B组之间(P<0.05);治疗后,3组患者的血脂、血糖、肝功能、肾功能水平比较均无显著差异(P>0.05)。结论乐卡地平能够有效控制患者的血压,但会导致患者出现反射性心率加快,必要时联合比索洛尔进行治疗;替米沙坦具有明显的降压效果,对肾素血管紧张素醛固酮系统活性具有抑制作用,适合作为单纯舒张期高血压治疗的首选药物。

Objective To compare the efficacy of amlodipine,bisoprolol and telmisartan in newly diagnosed patients with isolated diastolic hypertension. Methods 93 cases of newly diagnosed patients with isolated systolic hypertension,in our hospital were randomly divided into A group,B group and C group. A group received lacidipine treatment,B group was treated with bisoprolol treatment,C group was treated with telmisartan. During the treatment of patients with weekly blood pressure,heart rate and other indicators were measured and followed up. Treatment is last for 1 month,during which,patients＇ ECG,blood pressure,blood lipids,blood glucose,liver and kidney function and other related indicators were compared. Results After the treatment,the diastolic blood pressure of the three groups were significantly decreased. The diastolic blood pressure of group A was lower（ 8. 2 ± 1. 9） mmHg; The diastolic blood pressure of group B was decreased（ 6. 7 ± 2. 0） mm Hg; the diastolic blood pressure of group C was lower（ 7. 8 ± 1. 7） mmHg; there was no significant difference in diastolic blood pressure between group A and group C（ P〉0. 05）. And the decrease was greater than that of group B（ P〈0. 05）. After treatment,the heart rate of group A was significantly increased（ P〈0. 05）,however,bisoprolol could effectively control heart rate（ P〈0. 05） The decrease of heart rate in group C was between group A and group B（ P〈0. 05）. After treatment,there was no significant difference in blood lipid,blood glucose,liver function and renal function between the three groups（ P〉0. 05）. Conclusion Le Carvedide can effectively control the patient＇s blood pressure,however,will lead to patients with reflex heart rate increase,if necessary,combined with bisoprolol for treatment; Telmisartan with significant antihypertensive effect has an inhibitory effect on renin-angiotensin aldosterone system activity,which is suitable for simple diastolic hypertension treatment of the preferred drug.