螺内酯联合缬沙坦及氢氯噻嗪治疗老年难治性高血压的临床效果研究进展

Advances in Clinical Effects of Spironolactone Combined with Valsartan and Hydrochlorothiazide in the Treatment of Elderly Patients with Refractory Hypertension

目的探讨螺内酯联合缬沙坦及氢氯噻嗪治疗老年难治性高血压的临床效果研究进展。方法方便收集该院2015年12月-2018年4月收治的122例老年难治性高血压患者的临床资料,根据不同治疗药物的选择将其分为对照组(n=61)与治疗组(n=61),对照组施以缬沙坦及氢氯噻嗪等药物进行治疗,治疗组施以螺内酯联合缬沙坦及氢氯噻嗪等药物进行治疗,并且在治疗前后分别对患者进行血生化、血常规与尿常规等相关检测,分别对两组患者的治疗前与治疗2个月后的相关实验室指标检查、血压、心率等情况进行比较分析,同时观察两组患者的不良反应发生情况。结果治疗前,两组患者的相关实验室指标检查、血压、心率等情况差异无统计学意义(P>0.05);治疗后,治疗组的尿素氮降至(7.03±1.92)mmol/L,血肌酐、谷丙转氨酶与总胆固醇分别为(124.36±38.52)μmol/L、(33.26±10.24)U/L与(6.19±2.43)mmol/L,差异有统计学意义(t=3.966、2.220、2.546、4.202,P=0.000 1、0.028、0.012、0.000 1);收缩压、舒张压与心率分别为(124.61±2.01)mmHg、(83.51±4.09)mmHg与(70.52±3.04)次/min,差异有统计学意义(t=12.277、9.275、6.018,P=0.000);并且治疗组的不良反应发生率为4.92%,明显低于对照组的31.15%,差异有统计学意义((χ^2=14.196,P=0.000 2)。结论螺内酯联合缬沙坦及氢氯噻嗪治疗老年难治性高血压具有较好的临床效果,不仅能够有效的改善患者的相关实验室指标检查、血压、心率等情况,同时能够有效的降低患者不良反应发生情况。

Objective To investigate the clinical effects of spironolactone combined with valsartan and hydrochlorothiazide in the treatment of elderly patients with refractory hypertension.Methods The clinical data of 122 elderly patients with refractory hypertension admitted to our hospital from December 2015 to April 2018 were conveniently selected.The patients were divided into control group (n=61) and treatment group (n=61) according to the choice of different treatment drugs,the control group was treated with valsartan and hydrochlorothiazide,and the treatment group was treated with spironolactone combined with valsartan and hydrochlorothiazide,and blood biochemistry,blood routine and urine routine were performed before and after treatment.Correlation tests were performed to compare the laboratory indicators,blood pressure and heart rate of the two groups before and after treatment,and to observe the adverse reactions of the two groups.Results Before treatment,there were no statistically significant differences in laboratory indicators,blood pressure,and heart rate between the two groups (P>0.05).After treatment,the urea nitrogen in the treatment group decreased to (7.03±1.92) mmol/L,serum creatinine,alanine aminotransferase and total cholesterol were (124.36±38.52)μmol/L,(33.26±10.24)U/L and (6.19±2.43) mmol/L,respectively,and the difference was statistically significant (t=3.966,2.220,2.546,4.202,P=0.0001,0.028,0.012,0.0001);systolic blood pressure,diastolic blood pressure and heart rate were (124.61±2.01) mmHg,(83.51±4.09) mmHg and (70.52±3.04) times/min,respectively,and the difference was significant (t=12.277,9.275,6.018,P=0.000);and the incidence of adverse reactions in the treatment group was 4.92%,which was significantly lower than that of the control group (31.15%),and the difference was statistically significant (χ^2=14.196,P=0.000 2).Conclusion Spironolactone combined with valsartan and hydrochlorothiazide has a good clinical effect in the treatment of elderly patients with refractory hypertension.It can not only effectively improve the related laboratory indicators,blood pressure,heart rate,etc.,but also effectively reduce adverse reactions occurrence.