小剂量氢氯噻嗪和螺内酯在难治性高血压治疗中的联合应用
Combination Application of Low-Dose Hydrochlorothiazide and Spironolactone in the Treatment of Refractory Hypertension
李丹1
作者信息
- 1. 111000 辽宁 辽阳,辽阳市中心医院心内科
- 折叠
摘要
目的 探讨小剂量氢氯噻嗪和螺内酯对难治性高血压(resistant hypertension,RH)患者的治疗效果.方法 选择辽阳市中心医院2021年1月—2022年12月收治的RH患者80例,随机分为对照组和观察组各40例.两组患者基础治疗药物为硝苯地平、厄贝沙坦和哌唑嗪,对照组利尿剂选择小剂量氢氯噻嗪;而观察组则在其基础上加用小剂量螺内酯.比较两组治疗后心脏负荷、心脏结构及实验室指标变化情况.结果 治疗2周后,观察组收缩压、舒张压低于对照组,差异有统计学意义(P＜0.05);而两组心率差异无统计学意义(P＞0.05).治疗12周后,观察组左心房内径小于对照组,差异有统计学意义(P＜0.05);而两组左心室内径、室间隔厚度差异无统计学意义(P＞0.05).治疗4周后,两组谷丙转氨酶、谷草转氨酶、尿素氮、肌酐、血钾、甘油三酯和总胆固醇差异无统计学意义(P＞0.05).结论 小剂量氢氯噻嗪和螺内酯用于RH患者的治疗,可以进一步降低心脏负荷,改善心肌重塑,并且未对肝功、肾功、血脂造成明显的影响.
Abstract
Objective To explore the therapeutic effect of low-dose hydrochlorothiazide and spironolactone on patients with refractory hypertension(RH).Methods A total of 80 RH patients admitted to Liaoyang Central Hospital from January 2021 to December 2022 were randomly divided into a control group and an observation group,with 40 cases in each group.The basic treatment drugs for all patients were nifedipine,irbesartan,and prazosin.The control group chose low-dose hydrochlorothiazide as the diuretic,while the observation group added a small dose of spironolactone on top of it.The changes in cardiac load,cardiac structure,and laboratory indicators between two groups after treatment were compared.Results After 2 weeks of treatment,the systolic and diastolic blood pressure in the observation group were significantly lower than those in the control group(P<0.05).However,there was no significant difference in heart rate between the two groups(P>0.05).After 12 weeks of treatment,the left atrial diameter in the observation group was significantly smaller than that in the control group(P<0.05).However,there was no significant difference in left ventricular diameter and interventricular septum thickness between the two groups(P>0.05).After 4 weeks of treatment,there was no significant difference in the levels of alanine aminotransferase,aspartate aminotransferase,urea nitrogen,creatinine,blood potassium,triglycerides,and total cholesterol between the two groups(P>0.05).Conclusion Low dose hydrochlorothiazide and spironolactone can further reduce cardiac compliance,improve myocardial remodeling,and have no significant impact on liver function,kidney function,and blood lipids in the treatment of RH patients.
关键词
难治性高血压/氢氯噻嗪/螺内酯/联合/治疗/应用Key words
Refractory Hypertension/Hydrochlorothiazide/Spironolactone/Union/Treatment/Application引用本文复制引用
出版年
2024
NETL
NSTL
万方数据