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目的探讨ACEI类药物联合小剂量螺内酯治疗肾性难治性高血压的临床疗效及安全性。方法随机选取我院2008年6月-2011年6月诊治的肾性难治性高血压患者57例,对照组27例,在肾病的常规治疗基础上,给予依那普利10mg/d和硝苯地平缓稀片2.5mg/d,口服;治疗组30例,在对照组基础上给予小剂量螺内酯40mg/d,口服,两组疗程均为12周,观察两组治疗前后的临床疗效、降压效应及不良反应。结果治疗组经12周疗程治疗后,血压明显下降,临床总有效率达93.33%,均明显优于对照组(66.67%),差异有统计学意义(P<0.05),两组不良反应的发生率无明显差异(P>0.05)。结论在ACEI等常规降压治疗的基础上给予小剂量螺内酯,可显著改善肾性难治性高血压的疗效且无明显毒副作用。
Objective To investigate the clinical efficacy and safety of ACEI and low-dose spironolactone in the treatment of renal refractory hypertension. Methods 57 cases of renal refractory hypertension and 27 cases of control group were randomly selected from our hospital from June 2008 to June 2011. On the basis of routine treatment of renal disease, enalapril 10 mg / d and nitroglycerin Benzene to smooth tablets 2.5mg / d, orally; the treatment group 30 cases, given a small dose of spironolactone 40mg / d on the basis of the control group, orally, the two groups were treated for 12 weeks to observe the clinical efficacy of both groups before and after treatment, Pressure effects and adverse reactions. Results After treatment for 12 weeks, the blood pressure of the treatment group decreased significantly, the total effective rate was 93.33%, which was significantly better than that of the control group (66.67%), the difference was statistically significant (P <0.05). The incidence of adverse reactions There was no significant difference (P> 0.05). Conclusions The small dose of spironolactone given on the basis of ACEI and other conventional antihypertensive therapy can significantly improve the therapeutic effect of renal refractory hypertension without obvious side effects.