血管紧张素转化酶抑制剂用于高血压的疗效及对合并冠心病和脑卒中的二级预防效果  

Efficacy of ACEI in the treatment of hypertension and the effect of secondary prevention in patients complicated with coronary heart disease and stroke

作　　者：李杨[1] 刘俊法[1] 郝亚逢[1] 王学智[1] 

机构地区：[1]河北省邯郸市第一医院心内科,河北邯郸056000

出　　处：《南方医科大学学报》2017年第7期988-992,共5页Journal of Southern Medical University

摘　　要：目的探讨血管紧张素转化酶抑制剂(ACEI)类药物用于治疗高血压的疗效及对高血压合并冠心病和脑卒中二级预防效果。方法收集2012年1月~2015年12月来我院就诊的高血压患者210例,按随机数字法分为试验组和对照组,每组各105例。两组患者在常规对症治疗的基础上,试验组给予赖诺普利治疗,对照组给予卡托普利治疗,观察两组患者治疗前后血压参数、右上臂和右踝之间测到的脉搏波水平变化,比较两组患者冠心病和脑卒中的复发率及死亡率。结果治疗前两组患者的收缩压、舒张压、脉压差、右上臂和右踝之间测到的脉搏波水平无显著差异(P>0.05),治疗1个月、3个月后两组患者上述指标水平均显著降低,且试验组患者指标水平明显低于对照组(P<0.05);试验组患者冠心病复发率和脑卒中复发率明显低于对照组(P<0.05)。结论 ACEI类药物治疗高血压能够有效降低血压水平,改善动脉弹性功能,降低合并冠心病和脑卒中患者冠心病和脑卒中复发率,其中,赖诺普利的降压效果和对冠心病和脑卒中的二级预防效果更好,更值得临床推广应用。Objective To investigate the efficacy of ACEI drugs in the treatment of hypertension patients and the effect of two levels of prevention of hypertension complicated with coronary heart disease and stroke. Methods 210 cases of hypertension patients in our hospital from January 2012 to December 2015 were randomly divided into experimental group and control group, 105 cases in each group. According to the conventional symptomatic treatment, the experimental group was given lisinopril treatment, while control group was given the captopril treatment. Changes of blood pressure parameters and the level of baPWV in two groups were observed before and after treatment coronary heart disease and stroke, recurrence rate and death rate were compared in these two groups. Results No significant difference of SBP, DBP, PP and baPWV between two groups before treatment （P〉0.05）. The indexes of the two groups were significantly decreased after 1 months and 3 months, and the level of patients in the experimental group was lower than that of the control group （P〈0.05）. The recurrence rate in the experimental group was lower than those in the control group （P〈0.05）. Conclusions ACEI drugs in the treatment of hypertension can effectively reduce the level of blood pressure, improve arterial elasticity function, reduce the recurrence rate and mortality rate of coronary heart disease and stroke. The effect of antihypertensive and two levels of prevention of hypertension complicated with coronary heart disease and stroke of lisinopril is positive.

关 键 词：高血压 冠心病 脑卒中 赖诺普利 卡托普利 

分 类 号：R541.4[医药卫生—心血管疾病] R544.1[医药卫生—内科学] R743.3[医药卫生—临床医学]