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目的:应用动态血压监测评价复方依那普利与复方缬沙坦治疗轻中度原发性高血压的降压疗效。方法:40例平均坐位舒张压(SeDBP)为95~114 mmHg,且动态血压监测检查24 h平均舒张压≥82mmHg的轻中度原发性高血压患者,随机分为两组,接受复方依那普利(依那普利10 mg+氢氯噻嗪12.5mg),qd,或接受复方缬沙坦(缬沙坦80 mg+氢氯噻嗪12.5 mg),qd,治疗8周。在洗脱期末及治疗8周末各行动态血压监测和实验室检查1次。实验结束3个月后原两组轻中度原发性高血压患者又经2周洗脱期后,交叉接受复方缬沙坦或复方依那普利均qd,治疗8周,在洗脱期末及治疗8周末各行ABPM和实验室检查一次。结果:动态血压监测结果显示,两组治疗后24 h平均收缩压、舒张压均显著降低(P<0.001)。复方依那普利组收缩压、舒张压降低较复方缬沙坦组略明显,但两组间比较无统计学差异;复方依那普利组收缩压、舒张压降低的谷峰比分别为60.45%和53.24%;复方缬沙坦组分别为85.22%和78.96%;两组谷峰比值均>50%能维持24 h降压。不良反应少。结论:复方依那普利与复方缬沙坦治疗原发性轻中度高血压,均能有效降低收缩压、舒张压。每日1次口服可维持24 h平稳降压。
Objective: To evaluate the antihypertensive efficacy of enalapril and valsartan in the treatment of mild to moderate essential hypertension by ambulatory blood pressure monitoring. Methods: 40 patients with mean sedentary pressure (SeDBP) of 95-114 mmHg and 24 hours ambulatory blood pressure monitoring for patients with mild to moderate essential hypertension with 24 h mean diastolic blood pressure were randomly divided into two groups: Puli (enalapril 10 mg + hydrochlorothiazide 12.5 mg), qd, or receive compound valsartan (valsartan 80 mg + hydrochlorothiazide 12.5 mg) qd for 8 weeks. At the end of the elution and the end of the treatment of 8 weeks of each dynamic blood pressure monitoring and laboratory tests 1 time. Three months after the end of the experiment, the original two groups of patients with mild to moderate essential hypertension after two weeks of elution period, the compound received valsartan or compound enalapril were qd for 8 weeks, at the end of the elution And treatment ABPM and laboratory tests on the 8th weekend. Results: The results of ambulatory blood pressure monitoring showed that the average systolic and diastolic blood pressure decreased significantly at 24 h after treatment (P <0.001). Compared with compound valsartan, the systolic blood pressure and diastolic blood pressure in compound enalapril group were slightly lower than those in compound valsartan group, but there was no significant difference between the two groups. The peak-to-peak values of systolic blood pressure and diastolic blood pressure in compound enalapril group were 60.45 % And 53.24% respectively. The valsartan group was 85.22% and 78.96% respectively. The peak-to-peak ratio of both groups was> 50% Adverse reactions. Conclusion: Both enalapril and compound valsartan can effectively reduce systolic and diastolic blood pressure in patients with primary mild to moderate hypertension. Oral daily oral maintenance of 24 h stable antihypertensive.