南京地区社区人群抗高血压治疗的前瞻性队列研究

摘要目的：以社区抗高血压治疗的前瞻性随访队列为基础，观察复方利血平氨苯蝶啶降压效果和不良反应，及对血脂等生化指标的影响，为合理用药提供科学依据。方法：依托南京市慢性病防治体系，以新诊断高血压患者为研究对象，根据医嘱和患者自身需求，将其分为暴露组（复方利血平氨苯蝶啶治疗）和非暴露组（常规治疗），进行前瞻性队列研究，随访并检测其血压、血液生化指标以及记录不良反应等，队列随访至2012年12月底。结果：暴露组和非暴露组分别有390例和392例患者完成随访，平均治疗时间为2．17年。两组降压有效率分别为94．9％和97．4％，差异无统计学意义（P〉0．05）；两组不良反应发生人数分别为6例和2例，两组不良反应发生率的差异无统计学意义（P〉0．05）；两组总胆固醇、三酰甘油、天冬氨酸氨基转移酶、谷氨酸氨基转移酶、血清尿酸和空腹血糖在随访结束时差异亦无统计学意义（P〉0．05）。结论：基于前瞻性队列研究观察，复方利血平氨苯蝶啶具有和常规治疗药物类似的降压效果和安全性，对血液生化指标，尤其是血尿酸代谢无不良影响。

Prospective Cohort Study of Antihypertensive Therapy in Nanjing

Objective：To explore the effects of compound reserpine and triamterene on antihypertensive efficacy, adverse reactions and their impact on biochemical indexes based on a prospective cohort study of antihypertensive treatment in communities, and then proviae a scientific basis for the rational use. Methods： The prospective cohort study was conducted based on the chronic disease prevention and control system in Nanjing. The newly diagnosed hypertensive patients were divided into the compound reserpine and triamterene exposure group and the unexposed group （the conventional therapy） according to the doctor＇s advice and the patient＇s own needs. All the patients were followed up until the end of December 2012. Their blood pressure and serum biochemical indexes were detected and their adverse reactions, recorded. Results： 390 patients in the exposed group and 392 patients in the unexposed group finished their follow-up with the average treat- ment period of 2.17 years. The effective rates of the two groups were 94.9% and 97.4% respectively without any statistical differences （ P 〉 0.05 ）. 6 patients and 2 patients from the two groups respectively were found to have adverse reactions, but without any statistical differences（ P 〉 0.05 ）. In addition, no statistical differences were found between the two groups in total cholesterol, triglyceride, aspartate aminotransferase, alanine aminotransferase, serum uric acid and glucose at the end of the follow-up（P 〉0.05）. Conclusion：Based on the prospective cohort study, compound reserpine and triamterene had the same antihypertensive efficacy and safety as the conventional drugs, and there were no adverse effects on the blood biochemical indexes, especially on the uric acid metabolism.