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目的:观察螺内酯联合缬沙坦/氨氯地平及氢氯噻嗪治疗老年难治性高血压的临床效果。方法:70例老年难治性高血压患者,采取病例自身治疗前后血压进行对照研究,给予患者螺内酯20mg/d,缬沙坦/氨氯地平85mg/d或170mg/d口服,同时氢氯噻嗪片12.5mg/d,早起后口服;每天记录1次血压、心率、临床症状和不良反应等情况,疗程8周;期间4周左右可视血压情况调整缬沙坦/氨氯地平用量;治疗前后检测血生化、血常规和尿常规等;治疗前、治疗4周和治疗8周时行24h动态血压监测评估血压情况。结果:本组70例老年难治性高血压患者经治疗后血压达标率达97.1%,各项生化检查指标无明显改变。结论:螺内酯联合缬沙坦/氨氯地平及氢氯噻嗪是治疗老年难治性高血压的有效药物。
Objective: To observe the clinical effect of spironolactone combined with valsartan / amlodipine and hydrochlorothiazide in the treatment of senile intractable hypertension. Methods: A total of 70 elderly patients with refractory hypertension were enrolled in this study. Before and after treatment, the patients were treated with spironolactone 20mg / d, valsartan / amlodipine 85mg / d or 170mg / d orally, hydrochlorothiazide 12.5mg / d, Oral early after getting up; record blood pressure, heart rate, clinical symptoms and adverse reactions every day for 8 weeks; during the period of 4 weeks, the dosage of valsartan / amlodipine can be adjusted according to the visual blood pressure; , Blood and urine routine; before treatment, 4 weeks of treatment and 8 weeks of treatment when 24h ambulatory blood pressure monitoring assessment of blood pressure. Results: 70 cases of elderly patients with refractory hypertension blood pressure after treatment compliance rate of 97.1%, the biochemical indicators did not change significantly. Conclusion: Spironolactone combined with valsartan / amlodipine and hydrochlorothiazide is an effective drug for the treatment of senile intractable hypertension.