缬沙坦__(期刊论文)

缬沙坦与西拉普利治疗老年单纯收缩期高血压临床对比观察

http://www.100md.com 《新疆医科大学学报》 2005年第9期

缬沙坦,,缬沙坦；西拉普利；单纯收缩期高血压；老年人；超声心动图；,动态血压监测,1资料与方法,2结果,3讨论,参考文献：

     摘要: 目的：观察缬沙坦与西拉普利分别联用小剂量双氢克尿噻对老年单纯收缩期高血压(ISH)患者的降压效果及血清代谢指标、左心室肥厚(LVH)的影响。方法：68例老年ISH患者随机分为2组，缬沙坦组34例，每天口服80~160 mg缬沙坦+12.5 mg双氢克尿噻；西拉普利组34例，每天口服2.5~5 mg西拉普利+12.5 mg双氢克尿噻；2组治疗前及治疗6个月后均行24小时动态血压监测(24 hABPM)、心脏超声检查以及血清代谢指标测定，并对2组各指标进行了比较。结果： (1)不良反应：缬沙坦组胃部不适2例(6.06 %)，头昏1例(3.03 %)；西拉普利组干咳6例(17.65 %)。(2) 2组治疗后的24小时平均收缩压(24 hSBP)、白天平均收缩压(dSBP)和夜间平均收缩压(nSBP)均较治疗前明显下降(P<0.01)；2组组间治疗后各项血压指标相比差异均无统计学意义(P>0.05)。(3) 2组治疗前后的平均心率比较差异无统计学意义(P>0.05)。(4) 2组治疗后的左室重量指数(LVMI)均明显低于治疗前(P<0.01)。(5) 2组的空腹血糖(FBG)及血清钾(K+)、肌酐(SCr)、尿酸(UA)、总胆固醇(TC)、甘油三酯(TG)水平治疗前后比较差异均无统计学意义(P>0.05)。结论：缬沙坦与西拉普利分别联用小剂量双氢克尿噻均能够较好地降低老年ISH患者的收缩压，对伴发的LVH均有消退作用。

    关键词: 缬沙坦；西拉普利；单纯收缩期高血压；老年人；超声心动图；动态血压监测

    Comparison of valsartan or cilazapril in treatment of elderly patients with isolated systolic hypertension

    WANG Zhifeng， ZHANG Hua， ZHANG Xiaoyang， et al

    (Department of Geriatrics, Fifth Affiliated Hospital，Xinjiang Medical University, Urumqi 830011, China)

    Abstract: Objective： To study clinical efficacy, effect on metabolism and left ventricular hypertrophy(LVH)of valsartan or cilazapril combined with lowdose hydrochlorothiazide respectively in treating elderly patients with isolated systolic hypertension(ISH). Methods： Sixtyeight patients were divided randomly into two groups: 34 cases in valsartan group and 34 cases in cilazapril group, valsartan 80~160 mg/d plus hydrochlorothiazide 12.5 mg/d or cilazapril 2.5~5 mg/d plus hydrochlorothiazide 12.5 mg/d were given to patients in the two groups respectively. 24 hour ambulatory blood pressure monitoring (24hABPM), color echocardiography, serum metabolic parameters were evaluated before and after 6 months drug therapy and compared between the two groups. Results: (1) Side effects: stomach unwell(two cases, 6.06%) and dizzy (one case, 3.03%) occured in valsartan group, a dry cough (six cases, 17.65%) occured in cilazapril group. (2) The mean systolic blood pressure of 24 h, daytime and nighttime were lowered apparently after treatment compared with pretreatment in both groups(P<0.01). The parameters of 24hABPM after treatment were not statistically significant between the two groups (P>0.05). (3) The mean heart rate changes were not statistically significant before and after 6 months drug therapy in both groups(P>0.05). (4) The left ventricular mass index(LVMI) reduced significantly after treatment compared with pretreatment in both groups(P<0.01). The parameters of color echocardiography after treatment were not statistically significant between the two groups(P>0.05). (5) The changes of metabolic parameters such as serum K+, fasting blood glucose (FBG), serum creatinine(SCr), uric acid(UA), total cholesterol(TC), triglyceride(TG), were not observed in both groups before and after treatment(P>0.05). Conclusions: Valsartan or cilazapril combined with lowdose hydrochlorothiazide respectively in either case can lower effectively the SBP level in treating elderly patients with ISH and make left ventricular hypertrophy dispelled. ......

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