卡维地洛联合依那普利治疗高血压并心力衰竭的临床优势探讨  

Clinical advantages of carvedilol combined with enalapril in the treatment of hypertension with heart failure

作　　者：康超[1] KANG Chao(Jinxiang County People's Hospital,Jining 272200,China)

机构地区：[1]金乡县人民医院,272200

出　　处：《中国实用医药》2024年第14期11-14,共4页China Practical Medicine

摘　　要：目的探讨卡维地洛联合依那普利治疗高血压并心力衰竭的临床优势。方法200例高血压并心力衰竭患者,按随机数字表法分成对照组和研究组,各100例。对照组应用依那普利治疗,研究组在依那普利基础上联合应用卡维地洛治疗。对比两组患者临床疗效、不良反应发生率、血压指标、心肌损伤指标、心功能指标、生活质量评分。结果研究组总有效率98.00%比对照组的90.00%高(P<0.05)。两组不良反应发生率对比差异不明显(P>0.05)。两组治疗后收缩压和舒张压与治疗前对比均显著降低,且研究组收缩压(106.73±6.98)mm Hg(1 mm Hg=0.133 kPa)和舒张压(76.98±3.57)mm Hg比对照组的(117.95±8.51)、(82.17±4.60)mm Hg低(P<0.05)。治疗后,两组肌钙蛋白I、肌酸激酶同工酶、乳酸脱氢酶对比治疗前均显著降低,且研究组比对照组均更低(P<0.05)。治疗后,两组N末端B型利钠肽前体(NT-proBNP)、心肌做功指数(Tei指数)及左心室射血分数均较治疗前显著改善,且研究组NT-proBNP(358.49±27.84)ng/ml和Tei指数(0.32±0.10)均较对照组的(393.26±31.65)ng/ml、(0.44±0.11)更低,左心室射血分数(59.36±5.28)%较对照组的(53.17±4.52)%更高(P<0.05)。治疗后,两组生理、心理、环境及社会关系评分与治疗前相比均显著增高,且研究组均较对照组高(P<0.05)。结论高血压并心力衰竭患者应用依那普利联用卡维地洛治疗可增强疗效,更加有效地控制血压,保护心肌组织,改善心功能,有利于提高患者的生活质量,且未增加不良反应发生风险,用药安全性未受影响。Objective To explore the clinical advantages of carvedilol combined with enalapril in the treatment of hypertension with heart failure.Methods 200 patients with hypertension and heart failure were divided into a control group and a study group by random number table,each with 100 cases.The control group was treated with enalapril,and the study group was treated with carvedilol in addition to enalapril.The clinical efficacy,incidence of adverse reactions,blood pressure index,myocardial injury index,cardiac function index and quality of life score were compared between the two groups.Results The total effective rate of the study group was 98.00%,which was higher than 90.00%of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After treatment,the systolic blood pressure and diastolic blood pressure in both groups were significantly reduced compared with those before treatment;the study group had systolic blood pressure of(106.73±6.98)mm Hg(1 mm Hg=0.133 kPa)and diastolic blood pressure of(76.98±3.57)mm Hg,which were lower than(117.95±8.51)and(82.17±4.60)mm Hg in the control group(P<0.05).After treatment,the troponin I,creatine kinase isoenzyme and lactate dehydrogenase were significantly decreased in both groups compared with those before treatment,and the study group was lower than the control group(P<0.05).After treatment,N-terminal pro-B-type natriuretic peptide(NT-proBNP),myocardial performance index(Tei index)and left ventricular ejection fraction were significantly improved in both groups compared with those before treatment;the study group had NT-proBNP of(358.49±27.84)ng/ml and Tei index of(0.32±0.10),which were lower than(393.26±31.65)ng/ml and(0.44±0.11)in the control group;the study group had left ventricular ejection fraction of(59.36±5.28)%,which was higher than(53.17±4.52)%in the control group(P<0.05).After treatment,the scores of physiology,psychology,environment and social relations in both groups were significa

关 键 词：高血压 心力衰竭 依那普利 卡维地洛 

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