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目的:探讨氨氯地平(络活喜)与硫氮酮缓释片(合贝爽)联合治疗对单纯收缩期高血压(ISH)患者血压、动脉弹性功能、尿蛋白的影响。方法:选取74例单纯收缩期高血压患者,分别用氨氯地平(氨氯地平组,5 mg早晨一次,n=25)、硫氮酮缓释片(硫氮酮缓释片组,90 mg每日2次,n=23)、氨氯地平和硫氮酮缓释片联合治疗组(氨氯地平5 mg早晨一次+硫氮酮缓释片90 mg每日2次,n=26例)治疗8周,观察治疗前后血压,大小动脉弹性功能指数(C1、C2),尿α1-微球蛋白、尿微量白蛋白的变化。结果:氨氯地平组、硫氮酮缓释片组及联合治疗组治疗8周后均能显著地降低单纯收缩期高血压患者的血压水平,与治疗前比较差异有统计学意义(P<0.05);联合治疗组较氨氯地平组及硫氮酮缓释片组更显著降低患者的收缩压水平和脉压差,差异有统计学意义(P<0.05)。三组治疗8周后均可明显降低单纯收缩期高血压患者的尿α1-微球蛋白、尿微量白蛋白水平,改善患者大小动脉弹性功能指数,与治疗前比较差异有统计学意义(P<0.05);联合治疗组较氨氯地平组及硫氮酮缓释片组更显著,差异有统计学意义(P<0.05)。收缩压、舒张压和脉压差与大动脉弹性功能指数呈负相关(P<0.05),而与小动脉弹性功能指数无相关性;治疗后尿蛋白的下降程度与动脉弹性功能指标呈正相关(P<0.05),但尿蛋白的下降幅度与血压变化之间的相关性无统计学意义。结论:氨氯地平和硫氮酮缓释片联合治疗在控制单纯收缩期高血压患者收缩压,降低尿α1-微球蛋白、尿微量白蛋白,改善动脉弹性功能方面均具有协同作用。
Objective: To investigate the effects of combination of amlodipine and diltiazem on the blood pressure, arterial elasticity and urinary protein in patients with isolated systolic hypertension (ISH). Methods: Totally 74 patients with isolated systolic hypertension were treated with amlodipine (amlodipine, 5 mg in the morning, n = 25), norgezin sustained-release tablets 90 mg twice daily, n = 23), amlodipine and diazinon sustained-release tablets combined treatment group (amlodipine 5 mg once in the morning + diazinon sustained release tablets 90 mg twice daily, n = 26 cases) for 8 weeks. The changes of blood pressure, arterial elasticity index (C1, C2), urinary α1-microglobulin and urine microalbuminuria were observed before and after treatment. Results: After 8 weeks of treatment, the blood pressure of patients with isolated systolic hypertension was significantly lower than that of the patients treated with amlodipine and dehydrozifendan and the combination therapy group, with statistical significance (P <0.05) Compared with the amlodipine and diltiazem tablets, the combination therapy group significantly reduced the systolic blood pressure and pulse pressure difference (P <0.05). After 8 weeks of treatment, the urinary α1-microglobulin and urine microalbuminuria in the patients with isolated systolic hypertension and the index of arterial elasticity of the patients were significantly improved after 8 weeks of treatment, which were significantly different from those before treatment (P0.05) (P <0.05). The combination therapy group was more significant than the amlodipine and nisin sustained-release tablets group, the difference was statistically significant (P <0.05). Systolic blood pressure, diastolic blood pressure and pulse pressure were negatively correlated with arterial elasticity index (P <0.05), but not with arterial elasticity index (P> 0.05). After treatment, the decrease of urinary protein was positively correlated with arterial elasticity <0.05), but the correlation between the drop of urinary protein and blood pressure was not statistically significant. CONCLUSION: The combination therapy of amlodipine and diazinon sustained-release tablets has a synergistic effect in controlling systolic blood pressure, lowering urinary α1-microglobulin, urinary albumin, and improving arterial elasticity in patients with isolated systolic hypertension.