不同降压方案对老年高血压患者血压控制及左心室肥厚的影响

目的：探讨不同降压方案对老年高血压患者血压控制及左心室肥厚的影响，以期指导临床工作。方法选取2012年12月至2014年12月于我院内科住院治疗的162例高血压患者，按随机数表法分为观察组和对照组各81例，观察组患者接受氨氯地平联合氢氯噻嗪治疗，对照组则采用氨氯地平联合厄贝沙坦治疗，连续治疗2个月后，观察两组患者的血压、左室质量指数(LVMI)等指标，并进行对比分析。结果本组患者失访8例，治疗后，观察组患者的收缩压为(123±6) mmHg，对照组为(129±8) mmHg，均较同组治疗前明显下降(157±12) mmHg、(156±9) mmHg]且观察组低于对照组，差异均有统计学意义(P<0.05)；治疗后，两组患者的LVMI均较治疗前有不同程度减轻，观察组的LVMI为(124±18) g/m2，明显低于对照组的(132±16) g/m2，差异具有统计学意义(P<0.05)。结论氨氯地平联合厄贝沙坦方案和氨氯地平联合氢氯噻嗪方案均能降低患者血压，降低左室质量指数，其中以氨氯地平联合氢氯噻嗪的治疗效果更佳，值得临床推广应用。

Effect of different antihypertensive programs on blood pressure and left ventricular hypertrophy in elderly patients with hypertension

Objective To discuss the effect of different antihypertensive programs on blood pressure and left ven-tricular hypertrophy of elderly patients with hypertension, and to provide a guidance for clinical practice. Methods A total of 162 patients with hypertension in Department of Internal Medicine in our hospital were selected from December 2012 to December 2014, and randomly divided into the observation group and the control group according to random number table, with 81 patients in each group. The observation group was treated by amlodipine combined with hydrochlorothi-azide, and the control group was treated with amlodipine combined with irbesartan, for a treatment course of two mouths. The blood pressure, left ventricular mass index (LVMI), after treatment were compared between the two groups. Results Among the 162 patients, eight patients were lost to follow-up. After treatment, the systolic blood pres-sure of patients in observation group and the control group was (123 ± 6) mmHg, (129 ± 8) mmHg, respectively, which were significantly decreased compared with those before treatment (157 ± 12) mmHg, (156 ± 9) mmHg], and the value was significantly lower in observation group than control group (P<0.05). After treatment, the degree of LVMI were sig-nificantly reduced compared with before treatment, and the LVMI in observation group was significantly lower than that in the control group (124±18) g/m2 vs (132±16) g/m2, P<0.05]. Conclusion Amlodipine combined with irbesartan and amlodipine combined with hydrochlorothiazide can both reduce blood pressure and LVMI of patients. However, the treat-ment effect of amlodipine combined with hydrochlorothiazide is more significant, which is worthy of clinical populariza-tion and application.