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目的:探讨咪达普利与吲达帕联合治疗原发性高血压的临床疗效及对内皮依赖性舒张功能(FMD)的影响。方法:采用随机、平行、对照方法,307例高血压患者分3组:A组(61例)用吲哒帕胺2.5mg,qd;B组(118例)用吲哒帕胺2.5mg,qd,加美托洛尔25mg,bid;C组(128例)用吲哒帕胺2.5mg,qd加咪达普利5mg,qd。疗程均为8周。各组治疗2周后若偶测血压仍>140/90mmHg(1mmHg=0.133kPa)则药物剂量加倍(联合用药组吲哒帕胺剂量不变)。结果:3组高血压患者治疗8周后动态血压监测显示,除A组患者夜间平均收缩压(SBP)和平均舒张压(DBP)治疗前后差异无统计学意义外,其他动态血压指标均有明显改善(P<0·05)。心率除B组患者治疗后明显减低(P<0·01)外,其他2组治疗前后差异无统计学意义。治疗后组间血压各指标比较,B、C2组与A组均差异有统计学意义(P<0·05),而B组与C组之间均差异无统计学意义(P>0·05)。C组治疗后FMD有明显改善(P(0·01),而A、B2组治疗前后FMD无明显改变(P>0·05)。3组均未发现严重不良反应,A组有5例(8.2%)发生低钾血症,B组有3例(2.5%),C组未发现低钾血症;B组有8例(6.8%)出现心动过缓,A、C2组均未发现;C组有6例(4.7%)因干咳而退出试验,A、B2组均未发生。结论:咪达普利与吲达帕胺联合治疗高血压是一种较佳的组合,降压疗效较好,还具有改善内皮舒张功能的作用,不良反应少,且服用方便,价格便宜,可作为抗高血压药物联合治疗的优选方案。
Objective: To investigate the clinical efficacy of imidapril combined with indapat in the treatment of essential hypertension and its effect on endothelium-dependent diastolic function (FMD). Methods: A total of 307 hypertensive patients were randomly divided into 3 groups: group A (61 patients) received indapamide 2.5mg qd; group B (118 patients) received indapamide 2.5mg qd , Plus metoprolol 25mg, bid; C group (128 cases) with indapamide 2.5mg, qd plus imidapril 5mg, qd. The course of treatment is 8 weeks. After two weeks of treatment, even if the measured blood pressure was still> 140/90 mmHg (1 mmHg = 0.133 kPa), the dosage of the drug doubled (the dosage of indapamide in the combination group remained unchanged). Results: After 8 weeks of treatment, ambulatory blood pressure monitoring showed that no significant difference was found in the mean SBP and DBP before and after treatment in group A, and the indexes of other ambulatory blood pressure were all significant Improve (P <0.05). Heart rate in group B was significantly lower than that in group B after treatment (P <0.01), but there was no significant difference in other two groups before and after treatment. After treatment, the blood pressure among the two groups was significantly different (P <0.05), but there was no significant difference between group B and group C (P> 0.05) ). There was no significant difference in FMD between group A and group B before and after treatment (P> 0.05), and no significant adverse reactions were found in group C. There were 5 patients in group A 8.2%) had hypokalemia. There were 3 cases (2.5%) in group B and no hypokalemia in group C. 8 cases (6.8%) in group B had bradycardia and none in group A and C2. In group C, 6 patients (4.7%) withdrew from the test due to the dry cough, and none of the patients in groups A and B2. Conclusion: The combination of imidapril and indapamide is a better combination of antihypertensive drugs Good, but also has the role of improving endothelial function, adverse reactions, and easy to take, cheap, can be used as antihypertensive drugs combined treatment of the preferred option.