| 曾道亮.缬沙坦联合氢氯噻嗪对中、重度高血压患者的临床疗效及安全性研究[J].实用中西医结合临床,2023,23(11): |
| 缬沙坦联合氢氯噻嗪对中、重度高血压患者的临床疗效及安全性研究 |
| Clinical Efficacy and Safety of Valsartan Plus Hydrochlorothiazide in Patients with Moderate to Severe Hypertension |
| 投稿时间：2023-03-23 修订日期：2023-04-04 |
| DOI： |
| 中文关键词: 缬沙坦 氢氯噻嗪 中、重度高血压 |
| 英文关键词: Valsartan Hydrochlorothiazide Moderate to severe hypertension |
| 基金项目: |
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| 中文摘要: |
| 目的 分析氢氯噻嗪结合缬沙坦在中、重度高血压病人治疗中的效果及安全性。方法 选取我院于2019年2月~2022年2月内收治的164例中、重度高血压病人，依据其治疗手段差异分成2组。观察组89例病人实施氢氯噻嗪结合缬沙坦口服治疗，对照组75例病人实施非洛地平结合缬沙坦口服治疗，持续治疗12周。对比两组患者治疗前后的动态血压监测结果，对比两组患者血液中一氧化氮、内皮素、血清钾离子水平，对比两组患者治疗前后的心脏彩超结果，以及对比两组患者的不良反应发生率情况。结果 经过治疗，两组患者平均24h的收缩压(24hSBP)、平均24h的舒张压(24hDBP)、白天平均收缩压(dMSBP)、白天平均舒张压(dMDBP)、夜间平均收缩压(nMSBP)、夜间平均舒张压(nMDBP)均下降，且观察组患者的各项血压水平均低于对照组（P＜0.05）。治疗后，两组病人的血清一氧化氮升高、内皮素降低，且观察组病人血清内的一氧化氮浓度水平较对照组高（P＜0.05），观察组病人的内皮素浓度水平较对照组病人低（P＜0.05）。两组患者的左心房容积指数、左心室后壁厚度(PWT)及左心室舒张期内径(LVEDD)均较治疗前下降(P＜0.05)，观察组患者的左心房容积指数、PWT及LVEDD低于对照组(P＜0.05)。观察组患者治疗前后的血清钾离子浓度变化无统计学意义（P＞0.05），对照组患者血清钾离子浓度提高，且浓度高于观察组患者（P＜0.05）。对照组患者高钾血症发生率高于观察组（P＜0.05），但总不良反应出现概率方面，两组病人对比并无差异（P＞0.05）。结论 缬沙坦联合氢氯噻嗪能有效降低中、重度高血压患者的血压水平，有效缓解患者的左心室肥大、改善患者的血管内皮功能，稳定患者的血钾水平且不增加不良反应发生率。 |
| 英文摘要: |
| Objective To discuss the clinical efficacy and safety of valsartan plus hydrochlorothiazide in patients with moderate to severe hypertension. Methods One hundred and sixty-four patients with moderate to severe hypertension in our hospital from February 2019 to February 2022 were enrolled, and classified into 2 groups according to different treatment methods. Observation group (n=89) received oral valsartan combined with hydrochlorothiazide therapy, while control group (n=75) were given oral valsartan combined with felodipine. Then the blood pressure parameters, nitric oxide (NO) and endothelin-1 (ET-1), serum potassium ion concentration and adverse reaction rate were compared between 2 groups. Results The systolic blood pressure of 24-hour (24hSBP), diastolic blood pressure of 24-hour (24hDBP), mean systolic blood pressure of daytime (dMSBP), daytime mean diastolic blood pressure (n-DBP), mean systolic blood pressure of nighttime (nMSBP), and mean diastolic blood pressure of night (nMDBP) showed a decrease in both groups after treatment (P<0.05), and the above blood pressure parameters in observation group were all lower than control group after treatment (P<0.05). After treatment, an increase in nitric oxide and a reduction in endothelin-1 were observed in both groups (P<0.05), and observation group had higher nitric oxide and lower endothelin-1 levels than those of control group (P<0.05). Serum potassium ion concentration within observation group showed no significant changes before and after treatment (P>0.05), while the serum potassium ion concentration showed an increase in control group after treatment, and was higher than that of observation group (P<0.05). The left atrial volume index, posterior wall thickness (PWT), and LVEDD decrease in both groups after treatment (P<0.05), and the above 3 indicators of observation group were lower than control group (P<0.05). The incidence of hyperkalemia in control group was higher than observation group (P<0.05), but there was no statistical obvious in total adverse reaction rate between 2 groups (P>0.05). Conclusion Valsartan combined with hydrochlorothiazide in the treatment of moderate-to-severe hypertension can effectively reduce the blood pressure, relieve the left ventricular hypertrophy, improve the vascular endothelial function, stabilize the blood potassium level without increasing the incidence of adverse reactions. |
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