厄贝沙坦氢氯噻嗪联合硝苯地平控释片治疗老年顽固性单纯收缩期高血压分析

Analysis of irbesartan and hydrochlorothiazide combined with nifedipine controlled-release tablets in the treatment of refractory isolated systolic hypertension in the elderly

目的探讨分析针对顽固性单纯收缩期高血压老年患者应用厄贝沙坦氢氯噻嗪联合硝苯地平控释片实施治疗的方法及效果。方法将广东省汕头市澄海区人民医院2019年1—12月收治的顽固性单纯收缩期高血压老年患者60例作为研究对象并随机分组,对照组30例均接受吲达帕胺联合硝苯地平控释片治疗;研究组30例均接受厄贝沙坦氢氯噻嗪片联合硝苯地平控释片治疗。比较两组疗效。结果治疗6个月后,两组收缩压均显著降低,差异有统计学意义(P<0.05),研究组低于对照组,差异有统计学意义(P<0.05);两组治疗前后舒张压无显著变化,差异无统计学意义(P>0.05)。治疗前,两组24 h收缩压、舒张压及心率,差异无统计学意义(P>0.05);治疗后,研究组24 h收缩压低于对照组,差异有统计学意义(P<0.05),组间舒张压与心率接近,差异无统计学意义(P>0.05)。治疗前,两组血清肌酐、尿微量蛋白、肾小球滤过率等肾功能指标接近,差异无统计学意义(P>0.05);治疗后血清肌酐、尿微量蛋白指标均显著性下降,研究组低于对照组,差异有统计学意义(P<0.05);治疗后肾小球滤过率均显著性上升,研究组高于对照组,差异有统计学意义(P<0.05)。研究组总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。两组不良反应发生率均较低,对症治疗后均好转。结论针对顽固性单纯收缩期高血压老年患者应用厄贝沙坦氢氯噻嗪联合硝苯地平控释片实施治疗,临床疗效显著,有助于改善患者预后,值得推广应用。

Objective To explore and analyze the methods and effects of irbesartan hydrochlorothiazide combined with nifedipine controlled-release tablets in the treatment of refractory isolated systolic hypertension(ISH)in elderly patients.Methods A total of 60 elderly patients with refractory ISH treated in People’s Hospital of Chenghai Shantou from January to December 2019 were taken as research objects and randomly divided into two groups.30 cases in the control group were treated with indapamide combined with nifedipine controlled-release tablets.30 cases in the study group were treated with irbesartan hydrochlorothiazide tablets combined with nifedipine controlled-release tablets.The efficacy was compared between the two groups.Results After 6 months of treatment,the systolic blood pressure(SBP)in both groups decreased significantly,and the difference was statistically significant(P<0.05),and SBP of the study group was significantly lower than that of the control group,with statistically significant differences(P<0.05).There was no significant difference in diastolic blood pressure(DBP)between the two groups before and after treatment,with no statistically significant difference(P>0.05).Before the treatment,the 24-hour SBP,DBP and heart rate(HR)of the two groups were similar,and there was no significant difference(P>0.05).After treatment,the 24-hour SBP in the study group was significantly better than that in the control group,with statistically significant differences(P<0.05).DBP and HR of the two groups were similar,but there was no significant difference(P>0.05).Before treatment,the renal function indexes such as serum creatinine(Scr),urinary microprotein(UMP)and glomerular filtration rate(GFR)were similar between the two groups,with no statistically significant difference(P>0.05).After treatment,Scr and UMP decreased significantly in two groups,and those of the study group were significantly lower in than in control group,with statistically significant differences(P<0.05).After treatment,the GFR increased significantly in both groups,and GFR was significantly higher in the study group than in the control group,with statistically significant differences(P<0.05).The total effective rate of the study group was 93.33%,which was significantly higher than that of the control group73.33%,(P<0.05).The incidence of adverse reactions in both groups was low and improved after symptomatic treatment.Conclusion The application of irbesartan hydrochlorothiazide combined with nifedipine controlled-release tablets has significant clinical effect for elderly patients with refractory ISH,which is helpful to improve the prognosis of patients and is worthy of popularization and application.