【摘要】 目的探讨长效降压药治疗高血压合并体位性低血压的疗效及安全性。方法 2014年对华南农业大学教师体检,筛选出高血压合并体位性低血压、未规律服用降压药的患者113例,随机分为两组。治疗组给予长效降压药降压治疗,使其卧位血压达标,治疗过程中出现头晕、乏力等体位性症状者,给予静脉滴注参麦注射液改善症状。对照组给予安慰剂(复方维生素B)。分别在降压治疗前,治疗后1周、1个月、6个月、1年检测患者的临床症状评分、立卧位血压、立卧位血压差值、心脑血管等终点事件的发生率。结果治疗组患者降压治疗后各时间点与降压前相比,立卧位血压均显著下降(P<0.05);立卧位血压差值有缩小趋势,但差异无计学意义(P>0.05)。治疗后1周时临床症状评分增加,差异有统计学意义(P<0.05);治疗后1个月、6个月、1年临床症状评分无显著增加(P>0.05)。对照组患者用药后各时间点与用药前相比,立卧位血压及血压差值、临床症状评分差异均无统计学意义(P>0.05)。两组患者临床终点事件发生率相比,对照组较治疗组有增高趋势,但差异无统计学意义(P>0.05)。结论长效降压药治疗高血压合并体位性低血压,可有效控制卧位血压;体位性症状在用药后短期内有加重,给予对症处理后可明显缓解;终点事件发生率有减少趋势。说明长效降压药治疗高血压合并体位性低血压患者是安全、有效、可行的。更多还原

【Abstract】 Objective To study the curative effect of antihypertensive medications of prolonged action on the hypertensive patients with orthostatic hypotension. Methods 113 hypertensive patients with orthostatic hypotension were randomly divided into two groups. The treatment group was given antihypertensive medications of prolonged action,when the blood pressure was controlled,patients with symptoms of dizzy and weakness will be injected intravenously with Shenmai Injection. Vitamin B compound was given to patients in control group. The clinical symptom scores,differences of spine blood pressure,Orthostatic change in blood pressure and clinical outcome events were observed. Results The results showed that the supine blood pressure decreased significantly in the treatment group after the blood pressure was controlled(P<0.05),the change of blood pressure for upright and supine reduced slightly(P>0.05). The clinical symptom scores of patients increased after the antihypertensive medications were given for 1 week(P<0.05),and reduced after intravenoused Shenmai Injection(P >0.05). In the control group,the clinical symptom scores, the supine blood pressure and the difference of blood pressure for upright and supine changed little after giving vitamin B compound(P >0.05). The clinical outcome events in the control group increased slightly(P >0.05). Conclusion Antihypertensive medications of prolonged action can significantly control the supine blood pressure of the hypertensive patients with orthostatic hypotension,and can reduce the clinical outcome events slightly.更多还原