药物联用治疗原发性高血压的临床疗效观察

目的 评价小剂量HCTZ与氯沙坦或氨氯地平联用的降压疗效及安全性。方法 选择轻、中度高血压患者329例，经2周安慰剂洗脱期后随机分为氯沙坦组（50mg，Qd）或HCTZ＋氯沙坦组（HCTZ 12.5mg＋氯沙坦50mg，Qd）或HCTZ＋氨氯地平组（HCTZ 12.5mg＋氨氯地平5mg，Qd），共24周，每周随访一次。治疗前、后分别进行血生化检查并评估降压疗效及安全性。结果 （1）治疗后，三组患者的收缩压和舒张压较治疗前均呈明显下降（P＜0．01）。（2）HCTZ＋氯沙坦组、HCTZ＋氨氯地平组的降压达标率分别为48．5％、47．5％，均高于氯沙坦组（48．5％vs37．3％，P＜O．05；47．5％vs37．3％．P＜O．05）。（3）两组间不良反应发生率无统计学差异。结论 小剂量HCTZ与氯沙坦或氨氯地平联用降压安全、有效。

Antihypertensive Effects of Low-dose Hydrochlorothiazide in Combination with Losartan and AmlodiPine for Hypertension

Objective To assess the antihypertensive effects of low-dose hydrochlorothiazide（HCTZ） in combination with Losartan or AmlodiPine in mild or moderate hypertensive patients. Methods After two weeks＇washout period,329 patients were randomized to Losartan（50mg,Qd） group,HCTZ（12.5mg）/（50mg） Qd group or HCTZ（12.5mg）/AmlodiPine（5mg） Qd group. Antihypertensive effects were assessed among the three groups after 24 weeks. Results （1）After 6 months of treatment, blood pressure（BP） was significantly reduced in all groups（P〈 0.01,respectively）. And systolic blood pressure（SBP） were more decreased in the HCTZ/Losartan group or the HCTZ/AmlodiPine than that in Losartan group（16.7 ± 17.4）mmHg vs. （10.3±17.3）mmHg, P〈0.05;（15.6±16.4）mmHg vs.（10.3 ± 17.3）mmHg, P〈0.05]. （2）The response rate in HCTZ/Losartan group or the HCTZ/AmlodiPine group were higher than HCTZ group（48.5% vs. 37.3%, P〈0.05;47.5% vs. 37.3%, P〈0.05）. （3）Adverse events among three groups were comparable（P〉 0.05）. Conclusion The low-dose HCTZ in combination with Losartan or AmlodiPine is effective and safe for patients with essential hypertension.