阿司匹林肠溶片辅助替米沙坦联合硝酸异山梨酯片治疗高血压合并冠心病的效果观察  

Observation on the Effect of Aspirin Enteric-coated Tablets Combined with Telmisartan and Isosorbide Dinitrate Tablets in the Treatment of Hypertension Complicated with Coronary Heart Disease

作　　者：常超 王可为 张晓毅 葛晓松 CHANG Chao;WANG Kewei;ZHANG Xiaoyi;GE Xiaosong(Department of Cardiovascular Medicine,the First People's Hospital of Luoyang,Luoyang 471000,Henan,China)

机构地区：[1]洛阳市第一人民医院心血管内科,河南洛阳471000

出　　处：《中国药物滥用防治杂志》2025年第2期287-289,314,共4页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20191192)。

摘　　要：目的:探究阿司匹林辅助替米沙坦、硝酸异山梨酯片对高血压合并冠心病(CHD)患者血液流变学的影响。方法:选取2021年6月—2023年2月我院收治的92例高血压合并CHD患者作为研究对象,按照治疗方法不同分为观察组、对照组,各46例。对照组采用硝酸异山梨酯片+替米沙坦治疗,观察组于对照组基础上加用阿司匹林治疗。比较两组临床疗效、左室射血分数(LVEF)、血液流变学指标[血小板聚集率(PAR)、血浆黏度(PV)]水平、血管内皮功能指标[内皮素-1(ET-1)、一氧化氮(NO)、血管内皮依赖性舒张功能(FMD)]、血压[收缩压(SBP)、舒张压(DBP)]水平、炎性因子[血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、基质金属蛋白酶9(MMP-9)]水平及不良反应。结果:观察组总有效率为93.48%,高于对照组的73.91%(P<0.05);观察组治疗后LVEF、NO、FMD高于对照组,SBP、DBP、PAR、ET-1、PV、IL-6、hs-CRP、MMP-9低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:阿司匹林辅助替米沙坦、硝酸异山梨酯片治疗高血压合并CHD疗效确切,可促进血液流动,改善患者左心室收缩和扩张功能,还可显著控制血压,减轻炎症反应,且不增加药物不良反应。Objective:To explore the effect of aspirin assisted telmisartan and isosorbide dinitrate tablets on hemorheology in patients with hypertension complicated with coronary heart disease(CHD).Methods:From June 2021 to February 2023,92 patients with hypertension and CHD admitted to our hospital were selected as the research objects.According to different treatment methods,they were divided into observation group and control group,with 46 patients in each group.The control group was treated with isosorbide dinitrate tablets+telmisartan,and the observation group was treated with aspirin on the basis of the control group.The clinical efficacy,left ventricular ejection fraction(LVEF),blood rheology indicators[platelet aggregation rate(PAR)and plasma viscosity(PV)],vascular endothelial function indicators[endothelin-1(ET-1),nitric oxide(NO),and flow-mediated dilatation(FMD)],blood pressure[systolic blood pressure(SBP)and diastolic blood pressure(DBP)]levels,inflammatory factors[serum interleukin-6(IL-6),high sensitivity C reactive protein(hs-CRP),matrix metalloproteinase 9(MMP-9)]levels,and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 93.48%,which was higher than73.91%of the control group(P<0.05).After treatment,the LVEF,NO and FMD in observation group were higher than those of control group,SBP,DBP,PAR,ET-1,PV,IL-6,hs-CRP and MMP-9 were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Aspirin combined with telmisartan and isosorbide dinitrate tablets is effective in the treatment of hypertension complicated with CHD.It can promote blood flow,improve left ventricular systolic and diastolic function,significantly control blood pressure,reduce inflammatory response,and do not increase adverse drug reactions.

关 键 词：阿司匹林 冠心病 高血压 左室射血分数 血液流变学 

分 类 号：R541.4[医药卫生—心血管疾病]