缬沙坦分别联合氨氯地平与氢氯噻嗪治疗高血压患者的疗效比较

Valsartan combined with amlodipine versus valsartan combined with hydrochlorothiazide in treatment of patients with hypertension

目的比较缬沙坦分别联合氨氯地平及氢氯噻嗪治疗高血压的疗效与安全性。方法将老年高血压患者120例随机分为观察组与对照组,观察组采用缬沙坦联合氨氯地平,对照组采用缬沙坦联合氢氯噻嗪。比较2组患者治疗前后24 h血压水平变化以及一氧化氮(NO)、内皮素(ET)的变化,观察2组的血压达标及药物不良反应情况。结果2组治疗前24 h收缩压、舒张压差异无统计学意义(P>0.05);观察组治疗后24 h收缩压(126.5±8.9)mmHg,低于对照组的(134.8±9.1)mmHg,差异有统计学意义(P<0.05);治疗后观察组和对照组血压达标率分别为95.0%、93.3%;治疗后观察组和对照组患者的NO分别为(69.6±18.7)、(65.4±15.2)μmol/L,均高于本组治疗前的(27.5±13.5)、(27.6±13.4)μmol/L;ET分别为(33.2±4.5)、(37.1±5.4)ng/L,均低于本组治疗前的(45.5±8.2)、(45.8±8.4)ng/L;观察组治疗后血清NO高于对照组,ET低于对照组,差异均有统计学意义(P<0.05);治疗后观察组不良反应总发生率为8.3%,低于对照组的16.7%,差异有统计学意义(P<0.05)。结论缬沙坦联合氨氯地平能更有效地控制老年高血压患者的收缩压,提高血清NO水平,降低ET水平,保护血管内皮功能。

Objective To compare the efficacy and safety of valsartan combined with amlodipine and valsartan combined with hydrochlorothiazide in the treatment of patients with hypertension.Methods A total of 120 eldely patients with hypertension were randomly divided into observation group and control group.The observation group was treated with valsartan and amlodipine,while the control group was treated with valsartan and hydrochlorothiazide.The changes of 24 h blood pressure,nitric oxide(NO)and endothelin(ET)before and after treatment were compared between the two groups,and the condition of blood pressure reaching standard and adverse reactions of drugs were observed in both groups.Results There were no significant differences in 24 h systolic blood pressure and diastolic blood pressure before treatment between the two groups(P>0.05);the 24 h systolic blood pressure after treatment in the observation group was(126.5±8.9)mmHg,which was significantly lower than(134.8±9.1)mmHg in the control group(P<0.05).After treatment,the rates of blood pressure reaching standard in the observation group and the control group were 95.0%and 93.0%respectively.After treatment,the NO levels in the observation group and the control group were(69.6±18.7)and(65.4±15.2)μmol/L respectively,which were significantly higher than(27.5±13.5)and(27.6±13.4)μmol/L before treatment in both groups(P<0.05);the ET levels were(33.2±4.5)and(37.1±5.4)ng/L in the observation group and the control group,which were significantly lower than(45.5±8.2)and(45.8±8.4)ng/L before treatment in both groups(P<0.05);serum NO level after treatment in the observation group was significantly higher than that in the control group,and ET was significantly lower than that in the control group(P<0.05).After treatment,the total incidence rate of adverse reactions in the observation group was 8.3%,which was significantly lower than 16.7%in the control group(P<0.05).Conclusion For elderly patients with hypertension,valsartan combined with amlodipine can more effectively control systolic blood pressure,increase serum NO level,reduce ET level and protect vascular endothelial function.