目的：探讨氯沙坦钾氢氯噻嗪联合氨氯地平治疗难治性高血压的临床效果及安全性。方法将76例难治性高血压患者随机分为观察组及对照组两组，每组各38例，对照组给予氨氯地平、美托洛尔、氢氯噻嗪治疗，观察组给予氨氯地平、氯沙坦钾氢氯噻嗪片治疗，疗程均为8周，比较治疗前、后两组24 h SBP、DBP 变化，临床疗效及治疗期间两组不良反应发生情况。结果治疗后观察组24 h 动态 SBP、DBP 下降幅度优于对照组；观察组总有效率为84.2%，对照组为71.1%，组间比较差异均有统计学意义（P <0.05）。对照组治疗后血钾降低、血尿酸升高，与治疗前比较差异有统计学意义（P 0.05）。结论氯沙坦钾氢氯噻嗪联合氨氯地平治疗难治性高血压可增强降压效果，提高临床疗效，减少不良反应发生，临床疗效满意、安全性好。“,”Objective To explore the clinical effect and security of losartan potassium and hydrochlorothiazide combined amlodipine on refractory hypertension. Methods Seventy-six patients with refractory hypertension were randomly divided into observation group and control group,with 38 patients in each group. The patients in control group were treated with amlodipine,metoprolol and hydrochlorothiazide,and the patients in observation group were treated with amlodipine combined losartan potassium and hydrochlorothiazide tablets,all of the courses of the treatment were 8 weeks. The pa-tients’24 hours SBP and DBP change before and after the treatment,the clinical effects and the untoward effect occurrence during the treatment were compared. Results The 24 h dynamic SBP and DBP lowered range of the patients in observation group was superior to that of the patients in control group. The total effective rate of the observation group was 84. 2% and that of the control group was 71. 1% ,there was significant difference between the two groups(P < 0. 05). The serum potas-sium of the patients in control group was reduced and blood uric acid was raised after the treatment,there was significant difference compared with that before the treatment(P 0. 05). Conclusions The losartan potassium and hydrochlorothiazide combined amlodipine to treat the refractory hypertension can strengthen the antihypertensive efficacy,enhance the clinical effects and reduce the untoward effect occurrence. It has satisfactory clinical effect and good security.