不同降压方案对原发性3级高血压合并初发型心绞痛患者的影响  

Effect of different step-down schemes on patients with primary third level hypertension and initial onset angina pectoris

作　　者：李丹花[1] 赵晓燕[1] 

机构地区：[1]郑州大学第一附属医院心内科,450052

出　　处：《中国实用医刊》2015年第5期9-11,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察单用β-受体阻滞剂（β-b）或ARB类药物和联用二者对原发性3级高血压合并初发型心绞痛患者的心脏功能、结构及血管的影响。方法将入选的150例患者根据所服用的降压药物随机分为三组：钙通道阻滞剂（CCB）＋β—b组，CCB＋ARB组，CCB4-β-b＋ARB组；通过观察心力衰竭（HF）发生率、急性心肌梗死（AMI）发生率、舒张末期左室内径（LVEDD）、左室射血分数（LVEF）、左室后壁厚度（LVPWT）及Gensini评分来评估不同降压方案的获益。结果①对于治疗前和治疗后的CCB＋β—b＋ARB组，其β-b的平均服用剂量均小于CCB＋β-b组（P〈0．05）；其ARB的平均服用剂量均小于CCB＋ARB组（P〈0．05）。②治疗结束时观察到，治疗后CCB＋β-b组和CCB＋β-b＋ARB组的Gensini评分均小于CCB＋ARB组（P〈0．05），且均小于治疗前的Gensini评分（P〈0．05）；治疗后CCB＋β-b-4-ARB组的LVPWT小于CCB＋β-b组及CCB＋ARB组（P〈0．05），且小于治疗前的LVPWT（P〈0．05）。结论联用β-b和ARB较单用β-b或ARB在原发性3级高血压合并初发型心绞痛患者中获益更大。Objective To observe the effect of β-blocker （β-b） or ARB separately and combined drugs on the heart function, structure and cardiovascular of patients with third level hypertension and initial onset angina pectoris. Methods One hundred and fifty patients were divided into 3 groups according to the antihypertensive drugs they were taking ： CCB ＋β-b, CCB ＋ ARB, CCB ＋ β-b ＋ ARB. By observing the heart failure （HF） rate, acute myocardial infarction （AMI） rate, left ventricular end diastolic diameter（ LVEDD）, left ventricular ejection fraction（ LVEF）, left ventricular posterior wall thickness （LVPWT） and Gensini grades to evaluate the benefits of different step-down schemes. Results （1）As to the CCB ＋ β-b ＋ ARB berore and after treatment,its average dose of β-b was less than CCB ＋ β-b（P 〈 0.05）, and its average dose of ARB is less than CCB ＋ ARB （P 〈 0.05）. （2）At the end of treatment,the Gensini grades of CCB ＋β-b, and CCB ＋ β-b ＋ ARB after treatment are both less than CCB ＋ ARB（P 〈 0. 05 ） and both less than before treatment（ P 〈 0. 05 ）. The LVPWT of CCB ＋β-b ＋ ARB after treatment was less than CCB ＋ β-b and CCB ＋ ARB （P 〈 0.05 ）, and was less than before treatment（ P 〈 0.05 ）. Conclusions Combined usage of β-b and ARB has more benefits than separately in patients with primary third level hypertension and initial onset angina pectoris.

关 键 词：原发性高血压 初发型心绞痛 Β-受体阻滞剂 ARB 

分 类 号：R541.4[医药卫生—心血管疾病]