Objective To evaluate the efficacy and safety of perindopril combined with amlodipine or hydrochlorothia -zide in elderly hypertensive patients ,observe its infcuence on serum potassium ,Cystatin and uric acid .Methods Selected 60 cases of elderly hypertensive patients , they were randomly divided into two groups , given perindopril +amlodipine ( amlodip-ine group, n =30) or perindopril +hydrochlorothiazide (HCTZ group, n =30) antihypertensive treatment respectively , ob-served 24 h ambulatory blood pressure , detect serum potassium , serum cystatin and blood uric acid levels before and after treatment begin and eight weeks after treatment .Results Compared with before treatment , amlodipine and hydrochlorothiazide in blood pressure indicators were lower ( except hydrochlorothiazide group dDBP ) , and the former reduced rate significantly higher than the latter( P <0.05).After treatment, the amlodipine group was higher than standard blood pressure hydrochlo-rothiazide group (90.0%vs.76.7%, P <0.05).2 group antihypertensive drugs trough to peak ratios were greater than 50%, systolic blood pressure amlodipine group trough to peak ratio ( SBPT/P) is greater than the hydrochlorothiazide group (P <0.05), diastolic blood pressure trough to peak ratio (DBPT /P) is slightly larger than hydrochlorothiazide group , the difference was not statistically significant ( P >0.05).Compared with before treatment , after treatment, the two groups had improved blood pressure smoothness index ( P <0.05), and the amlodipine group than hydrochlorothiazide group ( P <0.05).After amlodipine treatment cystatin levels were significantly lower ( P <0.05), hydrochlorothiazide group also de-creased, but the difference was not statistically significant ( P >0.05).Uric acid levels in the two groups had no significant change in serum potassium ( P >0.05).Conclusion Perindopril and amlodipine or hydrochlorothiazide can significantly re-duce blood pressure in elderly hypertensive patients , but the former has better antihypertensive effect than the latter .Perindopril amlodipine acid in smoothness index raise blood pressure , improve blood pressure circadian rhythm , stable blood pressure , kidney and other aspects of the role of stronger protection may be more suitable for elderly patients with hypertension .%目的：探讨培哚普利联合氨氯地平或氢氯噻嗪治疗老年高血压患者的疗效、安全性及对血清钾、胱抑素及尿酸的影响。方法选取老年高血压患者60例，随机分为2组，分别给以培哚普利＋氨氯地平（氨氯地平组， n ＝30）或培哚普利＋氢氯噻嗪（氢氯噻嗪组， n ＝30）进行降压治疗，观察入选时和治疗8周后24 h动态血压及血钾、血清胱抑素和血尿酸水平。结果与治疗前相比，氨氯地平组和氢氯噻嗪组血压指标均有降低（氢氯噻嗪组dDBP除外），且前者的降低幅度明显高于后者（ P ＜0览．05）。治疗后，氨氯地平组血压达标率高于氢氯噻嗪组（90．0％ vs．76．7％， P ＜0．05）；2组药物降压谷峰比值均大于50％，氨氯地平组收缩压降压谷峰比（ SBPT/P）大于氢氯噻嗪组（P ＜0．05），舒张压降压谷峰比（DBPT/P）略大于氢氯噻嗪组，差异无统计学意义（ P ＞0．05）；与用药前相比，2组治疗后血压平滑指数均有提高（ P ＜0．05），且氨氯地平组高于氢氯噻嗪组（ P ＜0．05）。氨氯地平组治疗后胱抑素水平明显降低（ P ＜0．05），氢氯噻嗪组亦有降低，但差异无统计学意义（ P ＞0．05）；2组血钾、尿酸水平均无明显变化（P ＞0．05）。结论培哚普利联合氨氯地平或氢氯噻嗪均能明显降低老年高血压患者血压水平，但前者降压效果优于后者。培哚普利联合氨氯地平在提高血压平滑指数、改善血压昼夜节律、平稳降压、肾脏保护等方面作用更强，可能更适合老年高血压患者。
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