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目的探讨氯沙坦联合苯磺酸氨氯地平治疗老年高血压合并糖尿病的临床疗效。方法选取2013年12月—2014年12月黔南州人民医院收治的老年高血压合并糖尿病患者100例,随机分为氯沙坦组(30例)、苯磺酸氨氯地平组(30例)、联合治疗组(40例)。氯沙坦组患者予以氯沙坦治疗,苯磺酸氨氯地平组患者予以苯磺酸氨氯地平治疗,联合治疗组患者予以氯沙坦联合苯磺酸氨氯地平治疗。观察3组患者治疗前后血压变化情况、尿清蛋白排泄量及不良反应发生情况。结果治疗前3组患者收缩压、舒张压比较,差异无统计学意义(P>0.05);治疗后3组患者收缩压、舒张压比较,差异有统计学意义(P<0.05),联合治疗组患者收缩压、舒张压低于氯沙坦组和苯磺酸氨氯地平组,差异有统计学意义(P<0.05)。治疗前3组患者尿清蛋白排泄量比较,差异无统计学意义(P>0.05),治疗后3组患者尿清蛋白排泄量比较,差异有统计学意义(P<0.05),联合治疗组患者尿清蛋白排泄量低于氯沙坦组和苯磺酸氨氯地平组,苯磺酸氨氯地平组患者尿清蛋白排泄量低于氯沙坦组,差异均有统计学意义(P<0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论氯沙坦联合苯磺酸氨氯地平治疗老年高血压合并糖尿病的临床疗效显著,可改善患者血压,保护肾功能,且不良反应小。
Objective To investigate the clinical efficacy of losartan combined with amlodipine besylate in the treatment of elderly patients with hypertension and diabetes mellitus. Methods One hundred elderly hypertensive patients with diabetes mellitus admitted from December 2013 to December 2014 in Qiannan Prefecture People’s Hospital were randomly divided into losartan group (30 cases), amlodipine besylate group (30 cases) , Combined treatment group (40 cases). Losartan group was treated with losartan, amlodipine besylate group patients were treated with amlodipine besylate, and patients in combination group were treated with losartan and amlodipine besylate. The changes of blood pressure, urinary albumin excretion and adverse reactions before and after treatment were observed in 3 groups of patients. Results There was no significant difference in systolic pressure and diastolic pressure between the three groups before treatment (P> 0.05). The systolic pressure and diastolic pressure of the three groups after treatment were significantly different (P <0.05) Patients with systolic blood pressure and diastolic blood pressure were lower than the losartan group and amlodipine besylate group, the difference was statistically significant (P <0.05). There was no significant difference in urinary albumin excretion between the three groups before treatment (P> 0.05). There was significant difference in urinary albumin excretion between the three groups after treatment (P <0.05). The combined treatment group The urinary albumin excretion was lower than those in losartan and amlodipine besylate groups, but the urinary albumin excretion was lower in losartan group (P <0.05) ). There was no significant difference in the incidence of adverse reactions between the three groups (P> 0.05). Conclusion Losartan combined with amlodipine besylate in the treatment of senile hypertension complicated with diabetes has obvious curative effect, which can improve blood pressure and protect renal function with little side effects.