比索洛尔联合厄贝沙坦氢氯噻嗪治疗老年单纯收缩期高血压合并慢性心力衰竭的疗效  

Therapeutic effects of bisoprolol combined with irbesartan hydrochlorothiazide on senile isolated systolic hypertension complicated by chronic heart failure and its effects on BNP and cTnⅠ

作　　者：洪路贤 梁莉萍[1] 苗屈 HONG Luxian;LIANG Liping;MIAO Qu(Department of Geriatric Medicine,People＇s Hospital of Sanya City,Hainan,Sanya 572000,China)

机构地区：[1]海南省三亚市人民医院老年内科,572000

出　　处：《河北医药》2018年第19期2971-2974,共4页Hebei Medical Journal

摘　　要：目的探索比索洛尔联合厄贝沙坦氢氯噻氢治疗老年单纯收缩期高血压(ISH)合并慢性心力衰竭(CHF)的疗效及安全性。方法 96例ISH合并CHF的老年患者随机分为观察组和对照组,每组48例,在基础治疗基础上观察组服用比索洛尔联合厄贝沙坦氢氯噻嗪片,对照组不服用β-受体阻滞剂和利尿剂,疗程3个月。比较2组患者治疗效果,彩超测定左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF),用化学发光免疫法测定血清B型脑钠肽(BNP)和心肌钙蛋白Ⅰ(cTnⅠ)水平,记录治疗过程中发生的不良反应。结果 2组总有效率比较差异无统计学意义(P>0.05)。治疗后观察组LVEDD、LVESD和LVEF改善效果优于对照组(P<0.05)。治疗后观察组BNP和cTnⅠ改善效果优于对照组(P<0.05)。治疗期间观察组不良反应发生率低于对照组(P<0.05),其中观察组在外周水肿发生率方面显著低于对照组(P<0.05)。结论比索洛尔联合厄贝沙坦氢氯噻嗪治疗老年ISH合并CHF,疗效与其他疗法无明显差异,且可以有效改善心功能,明显降低不良反应的发生。Objective To explore the efficacy and safety of bisoprolol combined with irbesartan hydrochlorothiophene in treatment of isolated systolic hypertension（ ISH） with chronic heart failure（ CHF） in elderly patients. Methods Ninetysix elderly patients with ISH complicated by CHF were randomly divided into observation group（ n = 48） and control group（ n = 48）. On the basis of routine treatment,the patients in observation group were treated by bisoprolol combined with irbesartan hydrochloride,whereas those in control group were not treated with βblockers and diuretics,with a treatment course of 3 months for both groups. The therapeutic effects were compared in the two groups. The color Doppler ultrasonography was used to measure left ventricular end diastolic diameter（ LVEDD）,left ventricular end systolic diameter（ LVESD） and left ventricular ejection fraction（ LVEF）. The serum B-type brain natriuretic peptide（ BNP） and cardiac troponin Ⅰ（ cTnⅠ） levels were measured by chemiluminescence immunoassay. Adverse events during the treatment were recorded. Results There was no significant difference in total effective rate between two groups（ P〈0. 05）. After treatment,LVEDD,LVESD and LVEF were significantly improved in observation group,and the improvement effects in observation group were superior to those in control group（ P〈0. 05）. Moreover the improvement effects of BNP and cTnⅠ in observation group were superior to those in control group（ P〈0. 05）. In addition the incidence rate of adverse reactions in observation group was significantly lower than that in control group（ P〈0. 05）,in which,the incidence rate of peripheral edema in observation group was significantly lower than that in control group（ P〈0. 05）. Conclusion The efficacy of bisoprolol combined with irbesartan hydrochlorothiazide in treatment of senile ISH with CHF is not significantly different from the other therapies. In addition,the combination therapy can effectively improve cardiac fu

关 键 词：单纯收缩期高血压 慢性心力衰竭 比索洛尔 厄贝沙坦氢氯噻氢 

分 类 号：R541.6[医药卫生—心血管疾病]