培哚普利联合吲达帕胺治疗盐敏感性高血压的临床研究

目的 探讨培哚普利联合吲达帕胺对盐敏感性和非盐敏感性高血压的临床疗效和安全性。方法 将上海市虹口区江湾镇街道社区卫生服务中心2013年2月-2014年2月收治的128例高血压患者根据盐敏感性检测分为敏感组（66例）和非敏感组（62例），研究开始后两组患者均口服培哚普利片4 mg/d；吲达帕胺缓释胶囊1.5 mg/d，并根据血压逐渐调整用量，治疗8周后比较两组临床疗效、收缩压（SBP）、舒张压（DBP）、左心室重量指数（LVMI）、血浆血管紧张素Ⅱ（AngⅡ）和醛固酮（ALD）水平。结果 敏感组和非敏感组的总有效率分别为80.30%、70.97%，两组比较差异有统计学意义（P〈0.05）。治疗后两组患者SBP、DBP和LVMI均较治疗前有所减少，且敏感组减少程度更为显著，与非敏感组相比差异具有统计学意义（P〈0.01）。两组患者AngⅡ和ALD水平均较治疗前下降，与治疗前相比差异均有统计学意义（P〈0.01），且治疗后敏感组AngⅡ水平低于非敏感组，两组比较差异有统计学意义（P〈0.05）。结论 培哚普利联合吲达帕胺能够调节患者血浆AngⅡ和ALD水平，对盐敏感和非盐敏感性高血压均有较好的降压作用，且对盐敏感性高血压降压作用更为显著。

Clinical study of perindopril combined with indapamide in treatment of salt sensitive hypertension

Objective To explore the clinical efficacy and safety of perindopril combined with indapamide in the treatment of salt sensitivity/non salt sensitive hypertension. Methods Hypertension patients （128 cases ） in Jiangwan Community Health Center of Hongkou District of Shanghai City from 2013 February to 2014 February were divided into sensitive （66 cases） and non sensitive （62 cases） groups according to the salt sensitivity test. After the beginning of the study, all the patients were given Perindopril Tablet 4 mg/d; Indapamide Sustained Release Capsules 1.5 mg/d, then the dosages were gradually adjusted according to the blood pressure, compared the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, left ventricular mass index （LVMI）, plasma angiotensin Ⅱ（Ang Ⅱ）, and aldosterone （ALD） levels between the two groups after 8 weeks of the treatment. Results The total effective rates were 80.30% and 70.97% in the sensitive and non sensitive group, and there was significant difference between the two groups （P 〈 0.05）. SBP, DBR and LVMI levels decreased more after the treatment in the two groups than before the treatment, and the levels in the sensitive group decreased more obvious degree, the difference was statistically significant compared with non sensitive group （P 〈 0.01）. Ang Ⅱ and ALD levels decreased after the treatment in the two groups than before the treatment （P 〈 0.01）, and after the treatment the Ang Ⅱ level in the sensitive group was lower than that in the non sensitive group, and there was significant difference between the two groups （P 〈 0.05）. Conclusion Perindopril combined with indapamide could regulate the Ang Ⅱ levels in plasma of patients with hypertension, which has obvious antihypertensive effect to the both sensitive and non salt hypertension, but the effect on salt sensitive hypertension patients is obvious.