阿利沙坦酯治疗原发性高血压合并射血分数保留心衰的效果研究  

Efficacy of Allisartan Isoproxil in the Treatment of Essential Hypertension and Heart Failure with Preserved Ejection Fraction

作　　者：赵永福[1] 刘洋 李小玉 刘翠娴[1] 刘珊珊[1] ZHAO Yongfu;LIU Yang;LI Xiaoyu;LIU Cuixian;LIU Shanshan(Gaoming District People’s Hospital of Foshan City,Foshan 528500,China)

机构地区：[1]广东省佛山市高明区人民医院,广东佛山528500

出　　处：《中国医学创新》2020年第8期1-6,共6页Medical Innovation of China

基　　金：2018年佛山市自筹经费类科技计划项目(2018AB001874)。

摘　　要：目的:探讨阿利沙坦酯治疗原发性高血压合并射血分数保留心衰(HF-pEF)的临床效果。方法:选择2017年1月-2018年5月在佛山市高明区人民医院心内科进行治疗的原发性高血压合并HF-pEF患者106例,按照随机数字表法将患者分为对照组(n=53)和观察组(n=53)。对照组给予福辛普利、利尿剂、β1受体阻断剂抗心衰及改善心肌代谢药物等内科综合治疗,观察组给予阿利沙坦酯、利尿剂、β1受体阻断剂抗心衰及改善心肌代谢药物等内科综合治疗。对两组的治疗效果进行分析。结果:治疗后,对照组和观察组患者收缩压、舒张压、NYHA分级、血清NT-proBNP浓度与治疗前相比均降低(t=10.003、5.962、8.389、13.058、18.197、9.978、15.646、25.099,P<0.05);观察组治疗后的心率、收缩压、舒张压、血清NT-proBNP浓度均低于对照组(t=8.611、4.167、7.564、15.033,P<0.05)。治疗后,对照组和观察组患者左房容积指数、左心室质量指数、E/e′比值、三尖瓣最大反流速度与治疗前相比均降低,室间隔e′速度和侧壁e′速度与治疗前相比均上升(t=4.347、15.650、8.219、4.044、-18.611、-10.537、7.537、18.782、10.969、9.824、-28.478、-23.426,P<0.05);观察组治疗后的左房容积指数、左心室质量指数、E/e′比值、三尖瓣最大反流速度均低于对照组,室间隔e′速度和侧壁e′速度均高于对照组(t=2.842、7.321、4.125、5.047、-4.550、-14.531,P<0.05)。对照组和观察组患者治疗后的6 min步行试验结果与治疗前相比均提升(t=-29.951、-37.823,P<0.05),且在观察组治疗后的6 min步行试验结果优于对照组(t=-8.395,P<0.05)。观察组治疗效果优于对照组(Z=2.002,P<0.05)。两组患者的各项不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:利用阿利沙坦酯治疗原发性高血压合并HF-pEF患者,可以改善临床指标和治疗效果,安全性良好。Objective:To investigate the clinical effect of Allisartan Isoproxil in the treatment of essential hypertension and heart failure with preserved ejection fraction(HF-pEF).Method:From January 2017 to May 2018,106 patients with essential hypertension complicated with HF-pEF were treated in Department of Cardiology,Gaoming District People’s Hospital of Foshan City.Patients were divided into control group(n=53)and observation group(n=53)according to the random number table method.The control group was treated with Fosinopril,diuretics,β1 receptor blocker against heart failure and improving myocardial metabolism.The observation group was treated with Allisartan Isoproxil,diuretics,β1 receptor blocker against heart failure and improving myocardial metabolism.The therapeutic effects of the two groups were analyzed.Result:After treatment,the systolic blood pressure,diastolic blood pressure,NYHA classification,and serum NT-proBNP concentration in the control group and observation group were lower than those before treatment(t=10.003,5.962,8.389,13.058,18.197,9.978,15.646,25.099,P<0.05).Heart rate,systolic blood pressure,diastolic blood pressure,and serum NT-proBNP concentrations in the observation group were lower than those in the control group(t=8.611,4.167,7.564,15.033,P<0.05).After treatment,left atrial volume index,left ventricular mass index E/e′ratio and maximum tricuspid regurgitation velocity decreased in the control group and observation group compared with before treatment,while ventricular septal e′velocity and lateral wall e′velocity increased compared with before treatment(t=4.347,15.650,8.219,4.044,-18.611,-10.537,7.537,18.782,10.969,9.824,-28.478,-23.426,P<0.05).After treatment,the left atrial volume index,left ventricular mass index E/e′ratio and maximum tricuspid regurgitation velocity in the observation group were lower than those in the control group,and the ventricular septal and lateral wall e′velocities were higher than those in the control group(t=2.842,7.321,4.125,5.047,-4.550,-14.53

关 键 词：阿利沙坦酯 原发性高血压 射血分数 心力衰竭 

分 类 号：R544.11[医药卫生—心血管疾病]