硝酸脂类药物治疗老年单纯收缩性高血压分析

目的研究硝酸脂类药物对老年单纯收缩性高血压的治疗效果。方法随机选取我院2009年3月至2012年5月收入的老年单纯收缩性高血压患者68例为研究对象，按入院顺序分为观察组和对照组，各34例。两组均给予非洛地平治疗，观察组在此基础上再加用硝酸异山梨醇酯缓释片。治疗2个月后，观察对比两组的降压效果、血脂变化情况及不良反应的发生率。结果治疗后两组的血压均得到有效控制，较治疗前相比，舒张压变化不大，但收缩压与脉压差改善情况经统计学处理有显著差异（P〈0．05）；治疗后两组相比，观察组收缩压和脉压差较对照组均下降明显，有统计学差异（P〈0．05）。两组血脂水平经治疗均下降，但观察组甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）较对照组下降明显（P〈0．05）；对比不良反应的发生率，观察组为11．8％，而对照组为20．6％，经统计学处理，对照组显著高于观察组（P〈0．05）。结论以硝酸异山梨醇酯为代表的硝酸脂类药物对于老年单纯收缩性高血压的治疗效果显著，不仅可以显著改善收缩压和脉压差，缓解临床症状，而且能减少并发症的发生，提高老年患者的生存质量，值得临床推广。

Analysis of nitrates in treatment of senile isolated systolic hypertension

Objective To study the treatment effect of nitrates in the treatment of senile isolated systolic hypertension. Methods Sixty-eight patients with senile isolated systolic hypertension who were admitted to our hospital from March 2009 to May 2012 were selected randomly in our study. They were divided into observation group （n=34） and control group （n=3g） according to the order of admission. Both groups were given felodipine, and isosorbide mononitrate sustained release tablets were added in observation group. After 2 months of treatment, antihypertensive effect, blood lipids, and the incidence of adverse reactions were compared between the two groups. Results The blood pressure of the patients in two groups was controlled effectively after treatment. Compared with pre-therapy levels, there was little change in diastolic pressure, but systolic pressure and pulse pressure were significantly improved （P〈0.05）. After treatment, the observation group had significantly decreased systolic and pulse pressure compared with the control group （P〈0.05）. The levels of blood lipids in two groups were decreased, but the levels of triglyceride, total cholesterol, and high-density lipoprotein in observation group were decreased significantly compared with those in control group （P〈0.05）. The incidence of adverse reactions was 11.8% in observation group, versus 20.6% in control group, with a significant difference between the two groups （P〈0.05）. Conclusion Nitrates, represented by isosorbide mononitrate, have remarkable effect in the treatment of senile isolated systolic hypertension; they can not only significantly improve systolic and pulse pressure and relieve symptoms, but reduce complications and improve the life quality of elderly patients. This medication holds promise for clinical application.