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目的分析缬沙坦/氨氯地平复方制剂对原发性高血压患者颈动脉硬化的控制效果,为临床用药提供参考依据。方法选择2014年1月至2015年6月收治的120例中、重度原发性高血压伴颈动脉硬化病变患者作为研究对象,根据随机数字表法分为氨氯地平组、缬沙坦组和复方组各40例。氨氯地平组给予氨氯地平片治疗,缬沙坦组给予缬沙坦胶囊治疗,复方组给予缬沙坦/氨氯地平片治疗。治疗24周后比较三组患者的血压控制效果和颈动脉超声检查结果,多元线性回归分析法分析颈动脉内中膜厚度(IMT)的影响因素。结果治疗后,复方组收缩压、舒张压均明显低于氨氯地平组和缬沙坦组(P均<0.05);复方组IMT明显低于氨氯地平组和缬沙坦组(P均<0.05);三组治疗前后颈动脉斑块面积(PA)比较差异无统计学意义(P>0.05)。多元线性回归分析结果显示,IMT与治疗方法密切相关(P<0.05)。结论缬沙坦/氨氯地平复方制剂不仅提高了中、重度原发性高血压患者的降压效果,而且延缓了颈动脉硬化病变的进展,且无严重不良反应发生,值得临床重视。
Objective To analyze the control effect of valsartan / amlodipine compound on carotid atherosclerosis in patients with essential hypertension and provide reference for clinical use. Methods A total of 120 patients with moderate or severe essential hypertension with carotid atherosclerosis admitted from January 2014 to June 2015 were enrolled in this study. They were divided into amlodipine group, valsartan group and control group according to random number table Compound group of 40 cases. Amlodipine group were given amlodipine tablets, valsartan group was given valsartan capsules, and compound group was given valsartan / amlodipine tablets. After 24 weeks of treatment, the control effect of blood pressure and carotid ultrasonography were compared among the three groups, and the influencing factors of carotid IMT were analyzed by multivariate linear regression analysis. Results After treatment, the systolic blood pressure and diastolic blood pressure of the compound group were significantly lower than that of the amlodipine group and valsartan group (all P <0.05); the IMT of the compound group was significantly lower than that of the amlodipine group and the valsartan group (P < 0.05). There was no significant difference in carotid plaque area (PA) between the three groups before and after treatment (P> 0.05). Multivariate linear regression analysis showed that IMT was closely related to treatment (P <0.05). Conclusion Valsartan / amlodipine not only enhance the antihypertensive effect of patients with moderate and severe essential hypertension, but also delay the progression of carotid atherosclerosis without serious adverse reactions, which deserves clinical attention.