不同治疗方案治疗伴肾上腺增生高血压的临床疗效分析

目的探讨不同治疗方案治疗伴肾上腺增生高血压的临床疗效。方法将伴肾上腺增生高血压患者随机分为4组：A组：硝苯地平控释片30mg＋螺内酯20mg（，2—30），B组：硝苯地平控释片30mg＋螺内酯40mg（n=31），C组：硝苯地平控释片30mg＋厄贝沙坦片150mg＋螺内酯20mg（n=29），D组：硝苯地平控释片30mg＋厄贝沙坦片150mg＋安慰剂（n=29），出院后随访第1、2、3、4周及第2、3、6、9、12个月血压及电解质。评估各组治疗前后血压、电解质水平。结果（I）治疗12个月后4组收缩压下降幅度分别为13．4％、14．1％、18．0％、16．9％；舒张压下降幅度分别为17．5％、17-8％、24．7％、22．9％。（2）治疗第1、2、6、9、12个月C组收缩压低于其他各组，差异有统计学意义。（3）治疗第1、9、12个月c组舒张压低于其他各组，差异有统计学意义。（4）治疗后第6、9个月B组血钾高于其他组，第12个月B组、C组血钾高于其他组，差异有统计学意义。（5）A组显效率、有效率、无效率分别为66．7％、26．7％、6．6％，B组为80．6％、16．1％、3．3％，C组为86．2％、10．3％，3．5％，D组为82．8％、13．8％、3．4％。（6）4组患者治疗前后血钾与血压均呈负相关。（7）在治疗过程中B组出现男性乳房发育1例。结论4种治疗方案均可降低伴肾上腺增生高血压患者血压，但硝苯地平控释片30mg＋厄贝沙坦片150mg＋螺内酯20mg方案优于其它降压方案。

Different treatment options for hypertension with adrenal hyperplasia clinical perspective effect

Objective To explore the different treatment options for hypertension with adrenal hyperplasia clinical perspective effect. Methods The patients with adrenal hyperplasia of hypertension were randomly divided into four groups： group A.. nifedipine controlled release tablets 30 mg-4-spironolactone 20 mg （n ： 30） ; group B. nifedipine controlled release tablets 30 mg＋spironolactone 40 mg （n 31）, group C： nife dipine controlled release tablets 30 mg＋ Irbesartan Tablets 150 mg＋ spironolactone 20 mg （n ： 29）, group D： nifedipine controlled release tablets 30 mg＋Irbesartan Tablets 150 mg＋placebo （n =29）, After discharge follow-up of 1, 2, 3, 4 weeks and 2, 3, 6, 9 and 12 months of blood pressure and electrolyte. Assessed among groups before and after treatment of blood pressure, electrolyte levels. Results （1） 12 months after treatment of 4 set of systolic blood pressure decreased, respectively： 13.4%, 14.1%, 18.0%, 16.9%; Diastolic blood pressure decreased, respectively： 17.5%, 17.8%, 24.7%, 22.9%. （2） 1, 2, 6, 9and 12 months of systolic blood pressure is lower than other groups, group C was statistically significant. （3） 1, 9, 12 months of diastolic down from other groups, group C was statistically significant. （4） 6, 9 months in group B after treatment of potassium is higher than other groups, 12 months in group B, group C of potassium is higher than the other group, with statistical significance. （5） Group A significant effec- tive, efficient, inefficient were 66.7~//0, 26.70//00, 6.6~, group B was 80.60/oo, 16.1~//00, 3.3%, group C was 86.2%, 10.3~, 3.5~, group D was 82.8~//00, 13.8~//0, 3.40//00. （6） four groups before and after treatment in patients with potassium and blood pressure were negatively correlated. （7） An gynecomastia appears in group B during treatment. Conclusion Four kinds of treatment programs can reduce blood pressure in pa- tients with adrenal hyperplasia of hypertension, but nifedipine controlled release tablets 30 mgq-Irhesartan Tablets 150 mgq-spironolactone 20 mg program is superior to other antihypertensive programs.