改良限盐饮食控制终止高血压疗法对慢性心力衰竭合并高血压患者的影响  

Effects of modified salt limited dietary approaches to stop hypertension therapy in patients with chronic heart failure combined with hypertension

作　　者：田敏 徐凤 罗仁[1] 任娟 Tian Min;Xu Feng;Luo Ren;Ren Juan(Cardiovascular Medicine Department,First Division Hospital of Xinjiang Production and Construction Corps,Xinjiang 843000,China)

机构地区：[1]新疆阿克苏新疆生产建设兵团第一师医院心血管病科,843000

出　　处：《心脑血管病防治》2022年第3期17-20,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的 探讨改良的限盐饮食控制终止高血压(DASH)疗法对慢性心力衰竭合并高血压患者的影响。方法 选取2017年2月至2019年12月在新疆阿克苏新疆生产建设兵团第一师医院进行诊疗的慢性心力衰竭合并高血压患者142例,随机分为观察组71例和对照组71例。对照组患者采用低盐低脂饮食,观察组采用改良的限盐DASH疗法。随访1年后,比较两组患者干预前后的体质量指数、血压、血脂、心功能指标及药物使用等情况。结果 干预后,观察组患者的体质量指数、收缩压、舒张压、胆固醇及甘油三酯均明显低于对照组,而左心室射血分数、6 min步行距离均明显高于对照组,差异有统计学意义(t=3.395、2.971、4.368、2.013、2.705、9.931、14.615,P <0.05)。随访期间,观察组患者降压药物维持不变或增加情况比例显著低于对照组,减量或停药比例显著高于对照组,差异具有统计学意义(χ^(2)=5.174,P <0.05)。干预后与对照组比较,观察组颈动脉内膜中膜厚度显著降低(t=5.934,P <0.01)。治疗期间观察组平均每日盐摄入量显著低于对照组(t=24.062, P <0.01)。结论 改良的DASH疗法可有效降低慢性心力衰竭合并高血压患者的血压,改善心功能。Objective To explore the effect of modified salt limited dietary approaches to stop hypertension(DASH) therapy in patients with chronic heart failure(CHF) combined with hypertension. Methods From February 2017 to December 2019, 142 patients with CHF combined with hypertension in First Division Hospital of Xinjiang Production and Construction Corps were randomly divided into two groups: the observation group(71 cases) and the control group(71 cases).The patients in the control group were on a low salt and low fat diet, and the observation group was treated with salt limited DASH therapy. After one year of follow-up, the body mass index, blood pressure, blood lipid, heart function indexes and drug use of the two groups were compared before and after the intervention. Results After the intervention, body mass index, systolic blood pressure,diastolic blood pressure, cholesterol and triglycerides in the observation group were significantly lower than those in the control group, while left ventricular ejection fraction and 6-min walking distance were significantly higher than those in the control group, the differences were statistically significant(t=3.395,2.971, 4.368, 2.013, 2.705, 9.931, 14.615;P < 0.05). During the follow-up period, the proportion of patients who maintained or increased the doses of antihypertensive drugs in the observation group was significantly lower than that in the control group, and the proportion of patients who reduced the doses of drugs or stopped taking drugs was significantly higher than that in the control group, the difference was statistically significant(χ~2=5.174, P < 0.05). After intervention, the carotid intima-media thickness of the observation group was significantly lower than that of the control group(t=5.934, P < 0.01). The average daily salt intake of the observation group was significantly lower than that of the control group(t=24.062,P < 0.01). Conclusion The modified DASH therapy can effectively lower the blood pressure of patients with CHF combined with hypertension an

关 键 词：饮食控制终止高血压 慢性心力衰竭 高血压 

分 类 号：R541.6[医药卫生—心血管疾病] R544.1[医药卫生—内科学]