氯沙坦钾氢氯噻嗪联合硝苯地平控释片在老年顽固性单纯收缩期高血压治疗中的应用分析

Analysis on losartan potassium hydrochlorothiazide combined with nifedipine controlled release tablets in treatment of senile refractory isolated systolic hypertension

目的研究硝苯地平控释片和氯沙坦钾氢氯噻嗪联合应用对老年顽固性单纯收缩期高血压(ISH)的临床疗效及安全性。方法选取2017年1月~2018年1月于我院就诊的老年顽固性(ISH)114例,随机分为A组、B组、C组,每组38例,A组服用硝苯地平控释片,B组服用氯沙坦钾氢氯噻嗪片,C组两种药物联合,比较治疗前后血压、尿素氮、肌酐、血清胱抑素C、肾小球滤过率(eGFR)、尿微量白蛋白变化及不良反应发生率等指标。结果C组显效率、总有效率高于A组和B组(P均<0.05)。与治疗前相比,三组治疗后均eGFR升高,B组、C组mALB、CysC下降(P均<0.05)。治疗后比较,A组较B组eGFR下降,mALB、CysC升高(P均<0.05)。C组较A组和B组eGFR升高(P均<0.05),不良反应发生率比较,三组差异无统计学意义(P均>0.05)。结论与单药治疗相比,硝苯地平控释片和氯沙坦钾氢氯噻嗪联合治疗老年顽固性ISH疗效好、安全性高。

Objective To explore the curative effect and safety of nifedipine controlled release tablets combined with losartan potassium hydrochlorothiazide tablets in treatment of senile refractory isolated systolic hypertension (ISH). Methods 114 patients with senile refractory ISH who were treated in our hospital from January 2017 to January 2018 were selected.They were randomly divided into group A,group B and group C.The group A was treated with nifedipine controlled release tablets,group B was treated with losartan potassium hydrochlorothiazide tablets and group C was treated with nifedipine controlled release tablets and losartan potassium hydrochlorothiazide tablets.The changes of blood pressure, urea nitrogen,creatinine,serum cystatin C,estimate glomerular filtration rate (eGFR),urinary micro albuminuria and the incidence of adverse reactions were compared before and after treatment. Results The obvious effective rate and total effective rate were higher in group C than that in group A and group B (P < 0.05). Compared with that before treatment,eGFR increased in all the three groups,mALB and CysC decreased in group B and C (P < 0.05).After treatment, eGFR in group A was lower and mALB and CysC was higher than that in group B (all P < 0.05)).While compared with group A and group B, eGFR increased in group C (P < 0.05). There was no statistically significant difference in the incidence of adverse reactions among the three groups (P > 0.05). Conclusion Compared with single drug treatment,the treatment of losartan potassium hydrochlorothiazide tablets combined with nifedipine controlled release tablets has significant curative effects and safety in senile refractory ISH.