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目的:探讨厄贝沙坦联合氨氯地平治疗老年原发性高血压患者的临床效果。方法:以2015年1月至2016年12月接受单纯厄贝沙坦150 mg/日治疗且血压控制不达标的68例老年原发性高血压患者为研究对象,联合苯磺酸氨氯地平,观察治疗2周、4周、6周、8周、12周的血压变化和临床疗效,比较联合治疗前及治疗12周后血肌酐、血糖、血脂(总胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白)和尿酸水平的改变。结果:联合治疗2周、4周、6周、8周、12周的收缩压/舒张压由治疗前的(163.3±17.2/96.6±10.1)mm Hg分别变为(143.1±14.6/92.6±9.8)mm Hg、(132.6±10.4/89.2±7.6)mm Hg、(126.5±7.2/83.4±5.8)mm Hg、(123.7±6.6/82.8±4.4)mm Hg、(121.9±7.4/81.2±4.6)mm Hg,总有效率分别为98.6%、100.0%、100.0%、100.0%、100.0%,联合治疗前及治疗12周后血肌酐、血糖、总胆固醇、甘油三脂、高密度脂蛋白、低密度脂蛋白和尿酸水平分别为(106.38±31.86vs 99.29±21.25)μmol/L、(5.86±0.74 vs 5.69±0.65)mmol/L、(4.26±1.34 vs 4.38±1.41)mmol/L、(1.68±1.36 vs 1.69±1.35)mmol/L、(1.62±0.56 vs 1.58±0.53)mmol/L、(2.76±0.79 vs 2.62±0.73)mmol/L、(376.68±91.89 vs 351.78±83.52,P<0.05)μmol/L。结论:厄贝沙坦联合氨氯地平可有效降低单用厄贝沙坦疗效不佳的老年原发性高血压患者的血压,治疗12周可明显降低患者的血尿酸水平,但对血肌酐、血糖、血脂无明显影响。
Objective: To investigate the clinical effect of irbesartan combined with amlodipine in the treatment of elderly patients with essential hypertension. Methods: From January 2015 to December 2016, 68 elderly patients with essential hypertension who were treated with irbesartan alone at a dose of 150 mg / day and whose blood pressure was not controlled were enrolled in this study. Amlodipine besylate, The changes of blood pressure and clinical efficacy at 2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks of treatment were observed. Serum creatinine, blood glucose, blood lipid (total cholesterol, triglyceride, high density lipoprotein , Low density lipoprotein) and uric acid levels. Results: The systolic blood pressure / diastolic blood pressure at 2 weeks, 4 weeks, 6 weeks, 8 weeks and 12 weeks after combined therapy changed from 163.3 ± 17.2 / 96.6 ± 10.1 mm Hg to 143.1 ± 14.6 / 92.6 ± 9.8 ) mm Hg, (132.6 ± 10.4 / 89.2 ± 7.6) mm Hg, (126.5 ± 7.2 / 83.4 ± 5.8) mm Hg, (123.7 ± 6.6 / 82.8 ± 4.4) mm Hg and (121.9 ± 7.4 / 81.2 ± 4.6) mm Hg, the total effective rates were 98.6%, 100.0%, 100.0%, 100.0%, 100.0%, respectively. Serum creatinine, blood glucose, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein The protein and uric acid levels were (106.38 ± 31.86 vs 99.29 ± 21.25) μmol / L, (5.86 ± 0.74 vs 5.69 ± 0.65) mmol / L, (4.26 ± 1.34 vs 4.38 ± 1.41) mmol / L, (1.69 ± 1.35) mmol / L, (1.62 ± 0.56 vs 1.58 ± 0.53) mmol / L, (2.76 ± 0.79 vs 2.62 ± 0.73) mmol / L, . Conclusion: Irbesartan combined with amlodipine can effectively reduce the blood pressure of elderly patients with essential hypertension with irbesartan alone. After 12 weeks of treatment, the level of serum uric acid can be significantly decreased, but serum creatinine, Blood glucose, blood fat no significant effect.