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[目的]对比研究氢氯噻嗪和吲哒帕胺的降压疗效和安全性。[方法]选择55岁以上轻、中度原发性高血压病人72例,分为氢氯噻嗪组和吲哒帕胺组,分别给予氢氯噻嗪12.5 mg和吲哒帕胺2.5 mg每日1次口服,观察用药前后的血压水平及血尿酸(UA)、血钾、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和空腹血糖(FBG)等指标。[结果]两组治疗前后比较,收缩压(SBP)和舒张压(DBP)均明显下降(P均﹤0.01),但两组降压幅度差异无统计学意义(P﹥0.05)。两组治疗8周后血尿酸均明显升高(P均﹤0.01),血钾均明显降低(P均﹤0.01),但两组血尿酸增加值(48±23 vs.45±18)μmol/L,无统计学差异(P﹥0.05),血钾降低值(0.32±0.14 vs 0.38±0.18)mmol/L的差异无统计学意义(P﹥0.05)。两组治疗前后血糖和血脂各指标的变化无统计学意义(P均﹥0.05),两组低血钾的发生率差异无统计学意义(10.5%vs.14.7%,P﹥0.05)。[结论]氢氯噻嗪和吲哒帕胺均为可靠有效的降压药,对血糖血脂代谢均无明显影响,但二者降压幅度无统计学差异,升高血尿酸和降低血钾的不良反应的发生率相近,长期服用需注意监测。
[Objective] To compare the antihypertensive effect and safety of hydrochlorothiazide and indapamide. [Methods] Seventy-two patients with mild to moderate essential hypertension over the age of 55 were divided into hydrochlorothiazide group and indapamide group, and were given hydrochlorothiazide 12.5 mg and indapamide 2.5 mg orally daily for observation. The levels of blood pressure (UA), serum potassium, TC, TG, HDL-C, LDL-C and Fasting blood glucose (FBG) and other indicators. [Results] SBP and DBP decreased significantly in both groups before and after treatment (all P <0.01), but there was no significant difference between the two groups (P> 0.05). After 8 weeks treatment, serum uric acid increased significantly (both P <0.01) and serum potassium decreased significantly (P <0.01), but serum creatinine increased (48 ± 23 vs.45 ± 18) μmol / L, there was no statistical difference (P> 0.05). There was no significant difference in serum potassium between (0.32 ± 0.14 vs 0.38 ± 0.18) mmol / L (P> 0.05). There were no significant differences in the indexes of blood glucose and blood lipid between the two groups before and after treatment (P> 0.05). There was no significant difference in the incidence of hypokalemia between the two groups (10.5% vs.14.7%, P> 0.05). [Conclusion] Both hydrochlorothiazide and indapamide are reliable and effective antihypertensive drugs, and have no obvious effect on the blood glucose and blood lipid metabolism, but there is no significant difference between the two drugs in reducing blood pressure, increasing blood uric acid and lowering the adverse reaction of serum potassium Similar incidence, long-term use should pay attention to monitoring.