奥美沙坦酯与氨氯地平或氢氯噻嗪联合治疗原发性高血压的疗效比较

目的比较奥美沙坦酯联合氨氯地平与奥美沙坦酯联合氢氯噻嗪治疗原发性高血压的疗效。方法将206例2—3级原发性高血压患者完全随机分为观察组（奥美沙坦酯联合氨氯地平）和对照组（奥美沙坦酯联合氢氯噻嗪），每组103例，监测2组治疗前和治疗8周后24h动态血压，分析2组间降压效果及血压变异的差异，并观察治疗期间药物不良反应。结果治疗后2组患者24h平均收缩压及舒张压、白昼收缩压及舒张压、夜间收缩压及舒张压均较治疗前明显降低[观察组：（133±9）mmHg（1mmHg=0．133kPa）比（166±10）mmHg，（73±8）mmHg比（96±9）mmHg；（134±9）mmHg比（164±9）mmHg，（76±8）mmHg比（100±8）mmHg；（120±9）mmHg比（158±11）mrllHg；（72±7）mmHg比（94±8）mmHg。对照组：（130±7）mmHg比（164±11）mmHg，（75±7）mmHg比（97±8）mmHg；（131±8）mmHgI；L（164±10）mmHg，（79±7）mmHg比（101±8）mmHg；（129±8）mmHg比（160±9）mmHg，（80±8）mmHg比（102±8）InlllHg]，差异有统计学意义（P〈0．05），组间比较差异无统计学意义（P〉0．05）。白昼和夜间血压变异性2组差异有统计学意义（P〈0．05）。观察组和对照组降压总有效率分别为97．1％（100／103）和96．1％（99／103），差异无统计学意义（P〉0．05）。治疗期间2组不良反应发生率差异无统计学意义（P〉0．05）。结论奥美沙坦酯联合氨氯地平与氢氯噻嗪对原发性高血压患者降压效果较好，疗效相当且安全，奥美沙坦酯联用氨氯地平在血压变异性上控制较好。

Effect comparison of olmesartan combined with amlodipine and hydrochlorothiazide on patients with primary hypertension

Objective To compare the effect of olmesartan combined with amlodipine and hydrochlorothiaz- ide in primary hypertension treatment. Methods All 206 cases with primary hypertension （ stage 2 or 3） were randomly divided into group I （olmesartan combined amlodipine） and group 11 （olmesartan combined hydrochlorothiazide）, 103 cases in each group, 24 h ambulatory blood pressure before and after treatment were monitored, the differences between the two groups of antihypertensive effect and blood pressure variability were analyzed, and ad- verse drug reactions during treatment were observed. Results 24 h mean systolic blood pressure and diastolic blood pressure, daytime systolic blood pressure and diastolic blood pressure in two groups of patients after treatment significantly reduced more than those before treatment, the difference was significant （P 〈 0.05 ）, the difference between two groups after treatment was not significant （P 〉 0.05）. Daytime and nighttime blood pressure variability in group I was better than in group II （P 〈 0.05）. The antihypertensive efficiency of two groups were 97.1% （100/103） and 96. 1% （99/103） respectively, and there were no significant difference between the two groups （P 〉 0.05 ）. The adverse events of two groups were not significant difference during treatment （ P 〈 0.05 ）. Conclusion Olmesartan combined amlodipine have the same effect as olmesartan combined hydrochlorothiazide in lowering blood pressure, but the safety and the blood pressure variability is higher.