高危1级高血压患者初始联合降压治疗的效果(1)
【摘要】 目的：比较初始联合降压治疗与单药治疗对高危1级高血压患者的效果及安全性。方法：将初诊未服药治疗的高危1级高血压患者88例随机分为联合组(n=43)和单药组(n=45)。治疗第4、8周进行随访，观察血压及生化指标变化情况。结果：联合组治疗第4、8周收缩压及舒张压下降幅度均大于单药组，血压达标率、强化血压达标率均高于单药组，差异均有统计学意义(P<0.05)。两组治疗前后生化指标及不良反应发生率比较，差异均无统计学意义(P>0.05)。结论：对于高危1级高血压患者采用初始联合降压治疗方案可使血压达标率、强化血压达标率显著提高，且未增加低血压风险。
【关键词】 高危 1级高血压 初始联合降压治疗
doi：10.14033/j.cnki.cfmr.2020.16.022 文献标识码 B 文章编号 1674-6805(2020)16-00-03
Efficacy of Initial Combined Antihypertensive Therapy in High-risk Patients with First-grade Hypertension/WU Jiansheng. //Chinese and Foreign Medical Research， 2020， 18(16)： -57
[Abstract] Objective： To compare the efficacy and safety of initial combined antihypertensive therapy and monotherapy in high-risk patients with first-grade hypertension. Method： A total of 88 high-risk patients with first-grade hypertension who did not receive medication at the first diagnosis were randomly divided into the combined group (n=43) and the single drug group (n=45). All patients were followed up at 4 and 8 weeks of treatment， and the changes of blood pressure and biochemical indicators were observed. Result： At 4 and 8 weeks of treatment， the decreases in systolic blood pressure and diastolic blood pressure in the combined group were larger than those of the single drug group， and the blood pressure compliance rate and the enhanced blood pressure compliance rate were higher than those of the single drug group， and the differences were statistically significant (P<0.05). Biochemical indicators and the incidences of adverse reactions were compared between the two groups before and after treatment， and the differences were not statistically significant (P>0.05). Conclusion： For high-risk patients with first-grade hypertension， the blood pressure compliance rate and the enhanced blood pressure compliance rate are significantly increased by using the initial combined antihypertensive therapy， without increasing the risk of hypotension.
[Key words] High risk First-grade hypertension Initial combined antihypertensive therapy
First-author’s address： Songxi County Hospital， Songxi 353500， China
我國高血压患病率呈持续上升趋势，目前我国高血压患病人数高达2.45亿[1]。根据研究显示，我国成人高血压治疗率约45.8%，而控制率仅为16.8%[2]。积极降压治疗可以显著降低各种心脑血管并发症风险，目前对于血压≥140/90 mm Hg的非高龄、非衰弱状态患者也推荐选择初始联合降压治疗方案[3]。本研究旨在比较初始联合降压与单药治疗对高危1级高血压患者的效果及安全性。
1 资料与方法
1.1 一般资料
研究对象为2018年1月-2019年2月于松溪县医院就诊的88例高危1级高血压患者。纳入标准：(1)初诊且未接受过降压治疗;(2)年龄>18岁;(3)符合原发性1级高血压诊断标准，即140 mm Hg≤收缩压<160 mm Hg和/或90 mm Hg≤舒张压<100 mm Hg[4];(4)危险分层为高危或很高危。排除标准：(1)中重度肾功能不全;(2)严重肝功能受损;(3)胆道阻塞性疾病;(4)症状性瓣膜性心脏病。按随机原则分为联合组和单药组，联合组43例，男27例(62.80%)，女16例(37.20%);年龄(59.93±7.46)岁;吸烟史21例(48.84%);合并糖尿病14例(32.56%)，合并冠心病10例(23.26%)，合并卒中7例(16.28%)。单药组45例，男26例(57.78%)，女19例(42.22%);年龄(58.08±7.98)岁;吸烟史22例(48.89%);合并糖尿病13例(28.89%)，合并冠心病10例(22.22%)，合并卒中8例(17.78%)。两组性别、年龄、吸烟史、合并症比较，差异均无统计学意义(P>0.05)，具有可比性。本研究通过院伦理委员会批准，所有患者均签署知情同意书。, 百拇医药(吴建生)
【关键词】 高危 1级高血压 初始联合降压治疗
doi：10.14033/j.cnki.cfmr.2020.16.022 文献标识码 B 文章编号 1674-6805(2020)16-00-03
Efficacy of Initial Combined Antihypertensive Therapy in High-risk Patients with First-grade Hypertension/WU Jiansheng. //Chinese and Foreign Medical Research， 2020， 18(16)： -57
[Abstract] Objective： To compare the efficacy and safety of initial combined antihypertensive therapy and monotherapy in high-risk patients with first-grade hypertension. Method： A total of 88 high-risk patients with first-grade hypertension who did not receive medication at the first diagnosis were randomly divided into the combined group (n=43) and the single drug group (n=45). All patients were followed up at 4 and 8 weeks of treatment， and the changes of blood pressure and biochemical indicators were observed. Result： At 4 and 8 weeks of treatment， the decreases in systolic blood pressure and diastolic blood pressure in the combined group were larger than those of the single drug group， and the blood pressure compliance rate and the enhanced blood pressure compliance rate were higher than those of the single drug group， and the differences were statistically significant (P<0.05). Biochemical indicators and the incidences of adverse reactions were compared between the two groups before and after treatment， and the differences were not statistically significant (P>0.05). Conclusion： For high-risk patients with first-grade hypertension， the blood pressure compliance rate and the enhanced blood pressure compliance rate are significantly increased by using the initial combined antihypertensive therapy， without increasing the risk of hypotension.
[Key words] High risk First-grade hypertension Initial combined antihypertensive therapy
First-author’s address： Songxi County Hospital， Songxi 353500， China
我國高血压患病率呈持续上升趋势，目前我国高血压患病人数高达2.45亿[1]。根据研究显示，我国成人高血压治疗率约45.8%，而控制率仅为16.8%[2]。积极降压治疗可以显著降低各种心脑血管并发症风险，目前对于血压≥140/90 mm Hg的非高龄、非衰弱状态患者也推荐选择初始联合降压治疗方案[3]。本研究旨在比较初始联合降压与单药治疗对高危1级高血压患者的效果及安全性。
1 资料与方法
1.1 一般资料
研究对象为2018年1月-2019年2月于松溪县医院就诊的88例高危1级高血压患者。纳入标准：(1)初诊且未接受过降压治疗;(2)年龄>18岁;(3)符合原发性1级高血压诊断标准，即140 mm Hg≤收缩压<160 mm Hg和/或90 mm Hg≤舒张压<100 mm Hg[4];(4)危险分层为高危或很高危。排除标准：(1)中重度肾功能不全;(2)严重肝功能受损;(3)胆道阻塞性疾病;(4)症状性瓣膜性心脏病。按随机原则分为联合组和单药组，联合组43例，男27例(62.80%)，女16例(37.20%);年龄(59.93±7.46)岁;吸烟史21例(48.84%);合并糖尿病14例(32.56%)，合并冠心病10例(23.26%)，合并卒中7例(16.28%)。单药组45例，男26例(57.78%)，女19例(42.22%);年龄(58.08±7.98)岁;吸烟史22例(48.89%);合并糖尿病13例(28.89%)，合并冠心病10例(22.22%)，合并卒中8例(17.78%)。两组性别、年龄、吸烟史、合并症比较，差异均无统计学意义(P>0.05)，具有可比性。本研究通过院伦理委员会批准，所有患者均签署知情同意书。, 百拇医药(吴建生)