目的: 评价缬沙坦和氨氯地平联合治疗高血压的疗效及该用药方案对病人血压变异性的改善作用，
为高血压治疗中药物合理应用提供可靠证据。方法: 收集2013－10 ～ 2016－03 于我院就诊的≥18 岁的高血压病
人共124 例纳入研究; 以上入选病例按数字表法分至A、B 两组，进行为期12wk 的临床降压治疗对照试验; 其中
A 组给予缬沙坦+氨氯地平固定剂量口服治疗，B 组则给予缬沙坦+氢氯噻嗪固定剂量口服治疗; 主要评价指标
为入组基线以及治疗6wk、12wk 各时点降压效果及血压变异性的比较，次要评价指标为2 组6wk 末的血压达标
率及治疗过程中的新发不良事件记录。结果: 与治疗前基线参数相比，A、B 两组治疗6wk 和12wk 时24h SBP、
日间SBP、夜间SBP、晨峰SBP 及SBPV 水平均明显下降，统计学差异具有显著性( P＜0．05) ; 组间t 检验显示，与
B 组比较，A 组治疗6wk 及12wk 时，24h SBP、日间SBP、夜间SBP 及日间SBPV 水平均进一步下降( 均P＜0．05) ，
而治疗12wk 时，A 组24h SBPV 水平显示更低( P＜0．05) 。在治疗6wk 末的血压达标率和疗程中新发不良事件
的比较中，两组指标的统计学差异没有显著性( 均P＞0．05) 。结论: 在成人高血压治疗中，固定剂量下的缬沙坦
联合氨氯地平的用药方案，降压效果可靠，血压变异小，在血压控制和降低血压变异性方面，较缬沙坦联合氢氯
噻嗪的治疗方案更有优势。

Objective: Evaluation of valsartan and amlodipine on the curative effect of combined
treatment of high blood pressure and the regimen in patients with the effect of blood pressure variability，
provide medical evidence for drug application in hypertension treatment．Methods: Collected in October
2013 to March 2016 in our hospital of 18 years old or more，a total of 124 patients with hypertension
in research; the above selected cases according to the digital meter method points to A，B two
groups， for the clinical treatment for 12 weeks controlled trial; in which A group was given valsartan
plus amlodipine fixed doses of oral therapy，group B was given valsartan plus hydrochlorothiazide fixed
doses of oral therapy; group main evaluation index for the baseline，and treatment of 6 weeks，12 weeks
each point antihypertensive effect and the comparison of blood pressure variability， secondary evaluation
index for 2 set of 6 weekend treatment success rate and blood pressure in the process of new records of
adverse events． Results: Compared with the baseline parameters before treatmentA，B two groups of
treatment 6 weeks and 12 weeks and 24 hours SBP，daytime SBP and SBP at night，morning peak SBP
and SBPV levels were significantly lower，with significant difference statistically( P ＜ 0．05) ; between
group t test showed that compared with group B，group A treatment at 6 weeks and 12 weeks， 24 hours
SBP，daytime SBP and SBP at night and the daytime levels are further decreased( all P＜0．05) ，and after
12 weeks of treatment，24 hours SBPV level showed lower in group A( P＜0．05) ．The success rate
and blood pressure in the treatment of 6 weekend course new hair of adverse events， in the comparison
of the two groups of indicators of no significant difference statistically( P＞0．05) ．Conclusion: Uunder
the fixed dose of valsartan combined regimen of amlodipine， in the adult hypertension treatment，c an reduce
blood pressure，blood pressure change is small， in terms of blood pressure control and lower the
blood pressure variability，valsartan with hydrochlorothiazide treatment is better．

R544

 收稿日期: 2017－02－22; 修回日期: 2017－06－04
基金项目: 内蒙古卫生厅资助项目( 2006014)
作者简介: 张焕梅( 1972－) ，女，呼和浩特市第一医院副主任医师。
通讯作者: 王小玲，主任医师，E－mail: WXL@ 163．com 呼和浩特市第一医院功能检查科， 010030