| 曾道亮，黄美英，张建英，林滟含.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(13):1-5 |
| 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 |
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| DOI： |
| 中文关键词: 中、重度高血压 缬沙坦 氢氯噻嗪 |
| 英文关键词: Moderate to severe hypertension Valsartan Hydrochlorothiazide |
| 基金项目: |
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| 摘要点击次数: 129 |
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| 中文摘要: |
| 目的：分析氢氯噻嗪联合缬沙坦在中、重度高血压患者治疗中的效果及安全性。方法：选取医院于2019年2月至2022年2月收治的164例中、重度高血压患者，依据治疗方法不同分成两组。观察组89例患者实施氢氯噻嗪结合缬沙坦口服治疗，对照组75例患者实施非洛地平联合缬沙坦口服治疗，持续治疗12周。对比两组治疗前后动态血压监测结果，对比两组血清一氧化氮、内皮素、钾离子水平，对比两组治疗前后心脏彩超指标以及不良反应发生情况。结果：治疗后，两组患者平均24 h收缩压（24 h SBP）、平均24 h舒张压（24 h DBP）、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，且观察组各项血压水平均低于对照组（P＜0.05）。治疗后，两组血清一氧化氮水平升高、内皮素水平降低，且观察组血清一氧化氮水平较对照组高，内皮素水平较对照组低（P＜0.05）。两组左房容积指数、左室后壁厚度（PWT）及左室舒张末期内径（LVEDd）均较治疗前下降，且观察组低于对照组（P＜0.05）。观察组治疗前后血清钾离子水平比较，差异无统计学意义（P＞0.05），观察组血清钾离子水平降低，且低于对照组（P＜0.05）。观察组高钾血症发生率低于对照组（P＜0.05），但不良反应发生率方面，两组对比并无明显差异（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，有效缓解左心室肥大，改善血管内皮功能，稳定血钾水平且不增加不良反应发生率。 |
| 英文摘要: |
| Objective: To analyse the clinical efficacy and safety of hydrochlorothiazide combined with valsartan in patients with moderate to severe hypertension. Methods: 164 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 hydrochlorothiazide combined with valsartan therapy, while control group (n=75) were given oral felodipine combined with valsartan. The ambulate blood pressure monitoring results, serum nitric oxide, endothelin and potassium levels, cardiac color ultrasound indicators and adverse reactions were compared between the two groups before and after treatment. Results: The systolic blood pressure of 24-hour (24 h SBP), diastolic blood pressure of 24-hour (24 h DBP), mean systolic blood pressure of daytime (dMSBP), daytime mean diastolic blood pressure (dMDBP), mean systolic blood pressure of nighttime (nMSBP), and mean diastolic blood pressure of night (nMDBP) showed a decrease in both groups after treatment, all blood pressure levels in the observation group were lower than those in the control group (P＜0.05). After treatment, the serum nitric oxide level increased and endothelin level decreased in both groups, and the serum nitric oxide level in the observation group was higher than that in the control group, while the endothelin level was lower than that in the control group (P＜0.05). The left atrial volume index, left ventricular posterior wall thickness (PWT) and left ventricular end-diastolic diameter (LVEDd) in both groups were lower than before treatment, and the observation group was lower than the control group (P＜0.05). There was no significant difference in serum potassium level in the observation group before and after treatment (P＞0.05). The serum potassium level in the observation group was lower than that in the control group (P＜0.05). The incidence of hyperkalemia in the observation group was lower than that in the control group (P＜0.05), but there was no significant difference in the incidence of adverse reactions between the two 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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