拉西地平联合厄贝沙坦对老年单纯收缩期高血压患者的药效分析

目的 探讨拉西地平联合厄贝沙坦对老年单纯收缩期高血压（ISH）患者的脉压、尿β2微球蛋白、尿酸及血浆同型半胱氨酸的影响.方法 回顾性选择68例老年ISH患者,按所采用的治疗方法分为观察组及对照组,每组34例.观察组给予拉西地平4 mg/天,厄贝沙坦150 mg/天,均在早餐后服用;对照组给予苯磺酸氨氯地平片5 mg/天,早餐后服用,疗程12周.治疗期间均予低盐、低脂、低嘌呤饮食并戒烟酒.检测两组在治疗前后脉压、尿β2微球蛋白（β2-MG）、尿酸（UA）、血浆同型半胱氨酸（Hcy）和空腹血糖（FBG）的水平.结果 经12周治疗,观察组脉压、尿β2-MG、UA及Hcy水平明显下降（P〈0.05）,FBG无明显变化（P〉0.05）;对照组脉压比治疗前降低（P〈0.05）,尿β2-MG、UA及Hcy水平治疗前后比较差异无统计学意义（P〉0.05）,FBG无明显变（P〉0.05）;与对照组相比,观察组脉压、尿β2-MG、UA、Hcy水平明显降低,两组比较差异明显（P〈0.05）,FBG组间比较差异无统计学意义（P〉0.05）.观察组不良反应发生率为2/34（5.8%）,对照组为3/34（8.8%）（P〉0.05）.结论对于老年ISH患者,拉西地平联合厄贝沙坦可以平稳降低脉压,在一定程度上发挥保护肾脏的作用,是安全有效的药物.

Pharmacological Effect Analysis of Lacidipine Combined with Irbesartanin Elderly Patients with Isolated Systolic Hypertension

Objective To investigate lacidipine combined with Irbesartan effect on the pulse pressure,urine β2-microglobulin,uric acid and serum Homocysteine Level of elderly patients with the isolated systolic hypertension. Methods68 elderly patients with isolated systolic hypertension disease from Fenyang Hospital in Shanxi Province were selected and randomly divided into observation group （n=34）and control group（n=34）.The observation group was administered the lacidipine tablet 4 mg qd and the irbesartan tablets 150 mg qd after breakfast,and the control group was administered the amlodipine besylate tablets 5 mg qd after breakfast.During treatment,the patients should receive low-salt,low-fat and low-purine diets,abstain from alcohol and smoking.After 12 weeks,the blood pressure,urine β2-microglobulin,uric acid,serum homocysteine level and fasting blood-glucose level were collected. Results After 12-week treatment,pulse pressure,urine β2-microglobulin,uric acid and serum homocysteine levels of observation group decreased obviously（P〈0.05）,FBG levels had no statistical difference （P〉0.05）.Before and after treatment,pulse pressure of the control group decreased obviously（P〈0.05）,urine β2-microglobulin,uric acid,FBG and serum homocysteine levels had no statistical difference （P〉0.05）.Compared with control group,pulse pressure,urine β2-microglobulin,uric acid and serum homocysteine levels of the observation group were obviously lower （P〈0.05）,FBG levels had no statistical difference （P〉0.05）.The Adverse Reaction （ADR） incidence rate of the observation group was 5.8%,while that of the control group was 8.8%.The rate of ADR of these two groups was not different significantly （P〉0.05）. Conclusion Combined therapy with lacidipine and irbesartan can smoothly decrease pulse pressure of elderly patients with isolated systolic hypertension and play a role of kidney protection to a certain extent.Both of the drugs are safe and effective.