两种药物联合使用对老年高血压患者临床疗效的观察

目的：观察苯磺酸左旋氨氯地平联合坎地沙坦对老年高血压患者的疗效及用药安全性。方法将重庆市急救医疗中心于2012年10月至2013年3月收治的92例原发性老年高血压住院患者随机分为研究组、对照组1和对照组2。研究组共32例采用苯磺酸左旋氨氯地平联合坎地沙坦进行治疗，对照组1共30例采用苯磺酸左旋氨氯地平进行治疗，对照组2共30例采用坎地沙坦进行治疗，疗程均为8周。分别于治疗前、治疗后4周和8周进行24 h动态血压监测并记录24 h平均舒张压（DBP）和收缩压（SBP）、白天及夜间平均DBP和SBP、心率（HR）等指标，分析并比较各组的降压效果及用药产生的不良反应。结果3组患者治疗前与治疗后4周和8周24 h平均DBP和SBP、白天及夜间平均DBP和SBP均明显低于治疗前，差异具有统计学意义（P＜0．05）；研究组的总有效率为93．8％（30/32）与对照组1的总有效率76．7％（23/30）、对照组2的总有效率70．0％（21/30）相比较，差异均具有统计学意义（P＜0．05），对照组1与对照组2的总有效率比较差异无统计学意义（P＞0．05）。结论应用苯磺酸左旋氨氯地平联合坎地沙坦对老年原发性高血压的降压效果明显，可以有效控制血压降低，且具有用药剂量小、不良反应少等优点，是理想的联合降压方法，值得在临床上广泛推荐。

Clinical efficacy observation of levamlodipine besylate combined with candesartan in treatment of elderly hypertension

Objective To observe the clinical efficacy and safety of the treatment of elderly hypertension by levamlodipine besylate and candesartan .Methods 92 elderly patients with primary hypertension from October 2012 to March 2013 in our hospital were randomly divided into treatment group （n=32） which treated with levamlodipine besylate and candesartan ,the control group 1（n=30） which treated with levamlodipine besylate and the control group 2（n=30） which treated with candesartan .The three groups were treated for 8 weeks .The three groups were monitored by 24 hours ambulatory blood pressure monitoring （ABPM ） before treatment ,at 4 weeks and 8 weeks .The 24 hours average diastolic blood pressure （DBP） and systolic blood pressure （SBP） ,day-time average blood pressure , night-time average blood pressure and heart rate were recorded and analyzed .Results It was significant different compared to the 24 hours average blood pressure （DBP and SBP） ,day-time average blood pressure （DBP and SBP） , night-time average blood pressure（DBP and SBP） （P〈0 .05） .And the total efficiency of the treatment group ,control group 1 and control group 2 were 93 .8% （30/32） ,76 .7% （23/30） and 70 .0% （21/30） ,respectively .It was significant different between the treatment group and the control group （P〈0 .05） .And there was no significant different between the control group 1 and the control group 2（P〉0 .05） .Conclusion Levamlodipine besylate and candesartan were effective and safe drugs in treatment of elderly primary hypertension .The antihypertensive effect was obvious . And it had the advantages of small dosage and less adverse reaction .Therefore ,they are the ideal combination of antihypertensive methods ,it is worthy to be recommended in clinical .