硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压的临床观察

目的:观察硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压的临床疗效和安全性。方法:92例老年冠心病合并高血压患者按随机数字表法均分为对照组和研究组。对照组患者口服氢氯噻嗪25 mg,qd+尼群地平10 mg,qd+硝酸异山梨酯5 mg,tid;研究组患者口服硝苯地平缓释片20 mg,qd+依那普利初始5 mg,bid,2周后增加到10 mg,bid。两组患者疗程均为8周。观察两组患者的临床疗效,治疗前后舒张压(DBP)、收缩压(SBP),缺血事件发生率及不良反应发生情况。结果:治疗后两组患者总有效率及不良反应发生率比较,差异均无统计学意义(P>0.05)。治疗前两组患者DBP、SBP比较,差异均无统计学意义(P>0.05);而治疗后两组患者DBP、SBP均显著低于同组治疗前,且研究组显著低于对照组,差异均有统计学意义(P<0.05)。研究组患者缺血事件发生率显著低于对照组,两组比较差异有统计学意义(P<0.05)。结论:硝苯地平缓释片联合依那普利治疗老年冠心病合并高血压疗效显著,安全性较好。

Clinical Observation of Nifedipine Sustained-release Tablets Combined with Enalapril in the Treatment of Elderly Patients with Coronary Heart Disease and Hypertension

OBJECTIVE： To observe the clinical efficacy and safety of Nifedipine sustained-release tablets combined with enala- pril in the treatment of elderly patients with coronary heart disease and hypertension. METHODS ： 92 elderly patients with coronary heart disease and hypertension were randomly divided into study group and control group. Control group was treated with Hydro- chlorothiazide tablets 25 mg, po., once a day, Nitrendipine tablets 10 mg, po., once a day, and Isosorbide dinitrate tablets 5 mg, po., 3 times a day; study group was given Nifedipine sustained-release tablets 20 mg, po., once a day, and Enalapril tablet 5 mg, po., 2 weeks later increasing to 10 rag, twice a day. Treatment course of 2 groups lasted for 8 weeks. Clinical efficacy, the chang- es of DBP and SBP before and after treatment, the incidence of ischemic events and ADR were observed in 2 groups. RESULTS ： The total effective rate and the incidence of ADR in 2 groups had no statistical significance （P〉0.05）; the levels of DBP and SBP in 2 groups before treatment also had statistical significance （P〉0.05）. The levels of DBP and SBP in 2 groups after treatment were significantly lower than before, and those of study group were lower than those of control group; there was statistical signifi- cance （P〈0.05）. The incidence of ischemic events in study group was significantly lower than in control group; there was statisti- cal significance （P〈0.05）. CONCLUSIONS： Nifedipine sustained-release tablets combined with enalapril is effective in the treat- ment of elderly patients with coronary heart disease and hypertension with good security.