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目的:使用24h无创动态血压仪观察硝苯地平缓释片联合替米沙坦治疗中重度原发性高血压的疗效及观测肝肾功能、血尿常规判定其安全性。方法:选取50例中重度高血压病患者,予以每天口服硝苯地平缓释片20～40mg及替米沙坦40～80mg,疗程8周,接受治疗前后均进行24h无创动态血压监测及心率、血尿常规、肝肾功能和不良反应观察。结果:在治疗过程中,出现颜面部潮红3例,头部轻度胀痛伴头昏3例,均发生在开始用药3～10天内,且能够耐受,2周后自行消失。用药前后,血尿常规、肝肾功能、电解质未发生异常,24h平均SBP由(168.11±9.82)mmHg降至(132.31±4.82)mmHg,平均DBP由(94.13±10.26)mmHg降至(78.21±9.23)mmHg,24h血压基本在(140/90mmHg)以内。结论:硝苯地平缓释片联合替米沙坦口服能有效平稳地控制中重度高血压患者24h血压,安全可靠,耐受性好,不良反应少。
Objective: To observe the efficacy of nifedipine sustained-release tablets combined with telmisartan in the treatment of moderate-severe essential hypertension and to observe the liver and kidney function and hematuria routinely by 24-hour noninvasive ambulatory blood pressure monitor. Methods: Fifty patients with moderate-severe hypertension were enrolled and were given oral nifedipine sustained-release tablets 20-40mg and telmisartan 40-80mg daily for 8 weeks. Before and after treatment, non-invasive ambulatory blood pressure monitoring and heart rate, Hematuria, liver and kidney function and adverse reactions were observed. Results: In the course of treatment, there were 3 cases of facial flushing, mild head pain and dizziness in 3 cases, all occurred within 3 to 10 days after the start of medication, and were able to tolerate, disappear after 2 weeks. The mean SBP decreased from (168.11 ± 9.82) mmHg to (132.31 ± 4.82) mmHg, and the average DBP decreased from (94.13 ± 10.26) mmHg to (78.21 ± 9.23) mmHg before and after treatment with no abnormalities in hematuria, liver and kidney function, electrolyte, mmHg, 24h blood pressure is basically within (140 / 90mmHg). Conclusion: Nifedipine sustained-release tablets combined with telmisartan can effectively and smoothly control the blood pressure of patients with moderate-severe hypertension 24 hours, which is safe and reliable, tolerable and with few adverse reactions.