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目的比较螺内酯与特拉唑嗪治疗难治性高血压患者中的疗效和安全性。方法将47例难治性高血压患者,按就诊顺序,并参考患者基础血钾情况情况分为A组24例和B组23例;2组患者在继续使用原降压治疗方案的基础上,A组加用螺内酯,B组加用特拉唑嗪。2组在治疗4周后,比较2组患者诊室血压情况,并观察2组不良反应。结果治疗前2组收缩压、舒张压水平比较差异无统计学意义(P>0.05)。治疗后2组收缩压、舒张压水平均降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。特拉唑嗪组患者有2例治疗中出现头晕、头痛,但耐受良好,螺内酯未见不良反应。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论螺内酯较特拉唑嗪能更好降低收缩压,而特拉唑嗪则降低舒张压更优;特拉唑嗪组不良反应略高。
Objective To compare the efficacy and safety of spironolactone with terazosin in patients with refractory hypertension. Methods 47 patients with refractory hypertension were divided into group A (24 cases) and group B (23 cases) according to the order of treatment and with reference to the patients’ basal serum potassium status. On the basis of continuing the treatment program of original antihypertensive treatment, A group with spironolactone, B group with terazosin. Two groups after 4 weeks of treatment, comparing the two groups of patients blood pressure clinic, and observed two groups of adverse reactions. Results There was no significant difference in systolic blood pressure and diastolic blood pressure between the two groups before treatment (P> 0.05). After treatment, systolic blood pressure and diastolic blood pressure decreased in both groups (P <0.05), but there was no significant difference between the two groups (P> 0.05). Two patients in the terazosin group experienced dizziness and headache during treatment, but were well tolerated and spironolactone showed no adverse reactions. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusions Spalazosin can reduce systolic pressure better than terazosin, while terazosin can reduce diastolic blood pressure better; Terazosin group has slightly higher adverse reactions.