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目的探讨ACEI与长效CCB对高血压合并脑卒中二级预防的效果。方法回顾性分析2009年6月~2014年6月社区健康档案中高血压合并脑卒中存活>2个月的患者863例,以ACEI为降压基础治疗的408例,长效CCB为降压基础治疗的455例,主要观察脑卒中的复发、脑卒中死亡、心肌梗死发生及死亡、总死亡等,观察时间6~70个月,平均39个月。结果两组患者血压下降幅度比较差异无统计学意义(P>0.05);两组危险因素干预情况比较差异无统计学意义(P>0.05);ACEI组联合利尿剂的患者多于CCB组,差异有统计学意义(P<0.05);两组≥2种联合用药率相比,差异无统计学意义(P>0.05);ACEI组与CCB组所有脑卒中复发分别为111例(27.2%)、107例(23.5%),差异有统计学意义(P<0.05);两组其他心血管事件发生率比较,差异无统计学意义(P>0.05)。结论降压药对高血压合并脑卒中二级预防的效果与脑卒中一级预防相同,长效CCB优于ACEI。
Objective To investigate the effect of ACEI and long-acting CCB on secondary prevention of hypertension complicated by stroke. Methods From June 2009 to June 2014, 863 patients with hypertensive stroke complicated with stroke survived for 2 months from June 2009 to June 2014 were retrospectively analyzed. 408 patients were treated with ACEI as the basis of antihypertensive treatment, and the long-acting CCB was used as the basis of antihypertensive treatment 455 cases, the main observation of stroke recurrence, stroke death, myocardial infarction and death, total death, observation time 6 to 70 months, an average of 39 months. Results There was no significant difference in the decrease of blood pressure between the two groups (P> 0.05). There was no significant difference in the intervention of risk factors between the two groups (P> 0.05). There were more patients with combined diuretics in the ACEI group than in the CCB group (P <0.05). There was no significant difference between the two groups (P> 0.05). The recurrence rate of stroke in ACEI group and CCB group was 111 cases (27.2%), 107 cases (23.5%), the difference was statistically significant (P <0.05). There was no significant difference in the incidence of other cardiovascular events between the two groups (P> 0.05). Conclusion The effect of antihypertensive drugs on secondary prevention of hypertension complicated by stroke is the same as primary prevention of stroke. The long-acting CCB is superior to ACEI.