拜新同联合琥珀酸美托洛尔缓释片治疗顽固性高血压的临床疗效观察【摘要】目的探?硝苯地平控释片（拜新同）联合琥珀酸美托洛尔缓释片治疗顽固性高血压的临床效果。方法120例顽固性高血压患者，随机分为实验组及对照组，各60例。实验组给予拜新同联合琥珀酸美托洛尔缓释片治疗，对照组单纯给予拜新同治疗。比较两组患者的降压治疗效果、不良反应发生情况及治疗前后的血压变化情况。结果治疗8周后，实验组总有效率为90.0%，明显高于对照组的68.3%，差异具有统计学意义（P<0.05）。两组患者治疗8周后，实验组不良反应发生率15.0%明显低于对照组的33.3%，差异具有统计学意义（P<0.05）。治疗前两组患者收缩压及舒张压比较差异均无统计学意义（P>0.05）；治疗8周后，实验组收缩压及舒张压均明显低于对照组，差异具有统计学意义（P<0.05）。结论拜新同联合琥珀酸美托洛尔缓释片治疗顽固性高血压，具有良好的临床效果，且不良反应发生率低，安全性好，值得临床应用。【关键词】硝苯地平控释片；琥珀酸美托洛尔缓释片；顽固性高血压；临床疗效DOI：10.14163/jki.11-5547/r.2018.04.001Observationonclinicalefficacyofadalatcombinedwithmetoprololsuccinatesustained-releasetabletsinthetreatmentofrefractoryhypertension激ANGDan-yu.ShenyangShenheDistrictPeople’sHospital，Shenyang110001，China【Abstract】ObjectiveTodiscusstheclinicaleffectofnifedipinecontrolledreleasetablets（adalat）combinedwithmetoprololsuccinatesustained-releasetabletsinthetreatmentofrefractoryhypertension.MethodsAtotalof120refractoryhypertensionpatientswererandomlydividedintoexperimentalgroupandcontrolgroup，with60casesineachgroup.Theexperimentalgroupreceivedadalatcombinedwithmetoprololsuccinatesustained-releasetabletsfortreatment，andthecontrolgroupreceivedadalatfortreatment.Theeffectofantihypertensivetreatment，occurrenceofadversereactionandthechangeofbloodpressurebeforeandaftertreatmentwerecomparedbetweenthetwogroups.ResultsAfter8weeksoftreatment，theexperimentalgrouphadobviouslyhighertotaleffectiverateas90.0%than68.3%inthecontrolgroup，andthedifferencewasstatisticallysignificant（P<0.05）.After8weeksoftreatment，theexperimentalgrouphadobviouslylowerincidenceoftotaladversereactionsas15.0%than33.3%inthecontrolgroup，andthedifferencewasstatisticallysignificant（P<0.05）.Beforetreatment，bothgroupshadnostatisticallysignificantdifferenceinsystolicbloodpressureanddiastolicbloodpressure（P>0.05）.After8weeksoftreatment，theexperimentalgrouphadobviouslylowersystolicbloodpressureanddiastolicbloodpressurethanthecontrolgroup，andthedifferencewasstatisticallysignificant（P<0.05）.ConclusionCombinationofadalatandmetoprololsuccinatesustained-releasetabletsshowsexcellentclinicaleffectinthetreatmentofrefractoryhypertensionwithlowincidenceofadversereactionsandhighsafety.Itisworthyofclinicalapplication.【Keywords】Nifedipinecontrolledreleasetablets；Metoprololsustained-releasetablets；Refractoryhypertension；Clinicalefficacy顽固性高血压是指已经使用了3种以上合适剂量降压药（其中包括利尿剂）联合治疗，血压仍未能达到目标水平[140/90mmHg（1mmHg=0.133kPa）]以下，或者老年单纯收缩期高血压患者收缩压未降到160mmHg以下[1]。该病发病机制复杂，多种致病因素参与，同时也与患者个人体质及患者耐药性有一定关系[2]，长期血压得不到有效控制，会对患者心脏、肾脏、血管等靶器官造成严重损害，所以其降压治疗策略是临床医生亟待解决的问题。当一种降压药物无法控制血压时，采用联合用药来预防和控制高血压具有良好的效果，同时还可以减轻不良反应，得到世界卫生组织和国际高血压协会的认可和推荐[3，4]。本研究旨在观察拜新同联合琥珀酸美托洛尔缓释片治疗顽固性高血压的...