Objective To observe the efficacy of hydrochlorothiazide combined with enalapril or irbesartan in the treat-ment of moderate and severe primary hypertension. Methods Sixty-one patients with moderate and severe hypertension,who were enrolled in the hospital from February 2012 to August 2013,were selected and randomized into the group of hydrochlorothi-azide combined with enalapril(HE group,n=28)and the group of hydrochlorothiazide combined with irbesartan(HI group,n=33), and the clinical efficacy was analyzed by detecting blood pressure 8 weeks later. Results Blood pressure of both groups declined 8 weeks later. The effective rate was 89.3%(25/28) in the HE group and 87.9%(29/33) in the HI group,and the difference be-tween the two groups had no statistical significance(P>0.05). There were no significant difference on serum creatinine,blood uric acid,electrolyte,blood lipid and blood glucose in both groups before and after treatment(P>0.05). Conclusion Both hydrochloroth-iazide combined with enalapril and irbesartan have antihypertensive efficacy with synergistic effect ,they both can enhance the an-tihypertensive efficacy with little influence on metabolism.%目的：观察氢氯噻嗪联用依那普利或厄贝沙坦治疗中重度原发性高血压的临床疗效。方法选择2012年2月至2013年8月本院门诊及住院中重度高血压患者61例，随机分为氢氯噻嗪联合依那普利组（28例）、氢氯噻嗪联合厄贝沙坦组（33例），8周后测血压进行疗效分析。结果治疗8周后，两组患者血压均有明显下降。氢氯噻嗪联合依那普利组有效率为89.3%（25/28），氢氯噻嗪联合厄贝沙坦有效率为87.9%（29/33），两组比较，差异无统计学意义（P＞0.05）；两组治疗前后血肌酐、血尿酸、电解质、血脂、血糖等比较，差异无统计学意义（P＞0.05）。结论氢氯噻嗪联合依那普利与氢氯噻嗪联合厄贝沙坦降压效果均肯定，能发挥药物联用的协同作用，提高降压疗效，对代谢的影响小。
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