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目的 对比观察 4种降压药物联合方案长期治疗原发性高血压病 (EH)的疗效。方法 选择EHⅡ期、Ⅲ期患者 892例 ,按入选顺序分为 4组 :A组为尼群地平加卡托普利 ,B组为尼群地平加氨酰心安 ,C组为硝苯地平加卡托普利加双氢克尿噻 ,D组为复方降压片 ,各种原因退出以上 4组的为E组 ;在治疗前后检测血压、血尿常规、肾功能、2 4小时尿蛋白、眼底检查及心脏B超。部分患者检测了神经内分泌因子。结果 在治疗后 1、3年 ,5组患者动脉血压均较治疗前明显下降 ;LVMI和A/E比值均下降 ,CO和LVEF无变化 ,血BUN、Cr无变化 ,各组间无统计学差异。其中A、B、C组的 2 4小时尿蛋白、血尿酸明显下降 ,眼底情况明显改善 ,而D、E组则反之 ;心脑血管疾病死亡例数D、E组明显高于A、B、C组。结论 坚持长期降压治疗可明显减少高危患者的病死率和并发症 ,并保护其靶器官受损 ,制定合理、安全、有效、经济的降压方案对EH患者的管理率、服药率、控制率都有着重要的临床价值和社会意义
Objective To compare the curative effect of long-term treatment of essential hypertension (EH) with four antihypertensive drugs. Methods Eighty-two patients with stage EH and stage III were divided into 4 groups according to the order of preference: group A was nitrendipine plus captopril, group B was nitrendipamide and group C was nifedipine plus card Toplite hydrochlorothiazide, D group for the compound antihypertensive tablets, all kinds of reasons out of the above four groups for the E group; before and after treatment to detect blood pressure, urine, renal function, 24 hours urine protein, fundus examination and B-heart. Some patients tested neuroendocrine factors. Results The arterial blood pressure of the 5 groups decreased significantly after 1 and 3 years of treatment, the ratio of LVMI and A / E decreased, the changes of CO and LVEF did not change, the levels of BUN and Cr in serum did not change, and there was no significant difference among the groups . In group A, B and C, 24-hour urinary protein and serum uric acid were significantly decreased, fundus situation was significantly improved, while D and E groups were the opposite; death cases of cardiovascular and cerebrovascular diseases were significantly higher in groups D and E than in groups A and B, Group C Conclusion Insisting on long-term antihypertensive treatment can significantly reduce the mortality and complications of high-risk patients and protect their target organs from damage. To develop a reasonable, safe, effective and economical antihypertensive regimen for EH patients with management rate, medication rate, control rate All have important clinical value and social significance