摘要
目的:探究美亚沙坦钾片联合托伐普坦对高血压合并心力衰竭患者血管功能的影响。方法:将202例高血压合并心力衰竭患者分为对照组与观察组。对照组给予托伐普坦治疗,观察组在对照组基础上联合美亚沙坦钾片治疗。两组患者连续治疗12周,比较两组患者血压变异性、血管内皮功能、血管弹性功能、心功能、临床疗效及药物安全性。结果:对照组、观察组治疗后24 h动态血压监测分别为患者24 h平均收缩压[(141.26±11.36)mmHg,(125.35±10.28)]、日间平均收缩压[(149.02±11.56)mmHg,(135.61±10.53)]、夜间平均收缩压[(141.72±11.77)mmHg,(123.40±10.61)]、晨起平均收缩压[(144.12±12.13)mmHg,(125.11±10.17)]、24 h平均舒张压[(83.68±9.63)mmHg,(70.15±8.31)]g、日间平均舒张压[(87.45±8.65)mmHg,(79.55±8.08)]、夜间平均舒张压[(93.66±12.68)mmHg,(81.47±11.21)]、晨起平均舒张压[(83.68±9.63),(67.53±7.11)]mmHg,组间比较,观察组低于对照组,差异均具有统计学意义(均P<0.05);观察组反应性充血指数(RHI)、一氧化碳(NO)及内皮依赖性血管舒张功能(FMD)高于对照组[(1.89±0.11)%与(2.25±0.45)%,t=7.810,P<0.05;(63.83±11.56)μmol·L^(-1)与(72.18±12.76)μmol·L^(-1),t=4.873,P<0.05;(7.15±2.03)%与(9.05±1.57)%,t=7.440,P<0.05],血管内皮素-1(ET-1)低于对照组[(66.13±6.34)%与(50.33±6.43)%,t=17.584,P<0.05];观察组血管弹性功能以及心功能改善程度高于对照组(P<0.05);观察组联合用药后的疗效相较于对照组更好(P<0.05);两组患者药品不良反应出现次数,差异无统计学意义(P>0.05)。结论:美亚沙坦钾片联合托伐普坦可显著提升临床疗效,促进血管内皮细胞损伤修复,改善患者血管功能。
Objective:To investigate the effect of meixartan potassium tablet combined with tolvaptan on vascular function in patients with hypertension complicated with heart failure.Methods:A total of 202 patients with hypertension complicated with heart failure were divided into a control group and an observation group.The patients in the control group were treated with tolvaptan,and patients in the observation group with meixartan potassium tablets on the basis of the control group.The blood pressure variability,vascular endothelial function,vascular elasticity function,cardiac function,clinical efficacy and drug safety were compared between the 2 groups.Results:After treatment,the 24 h average SBP,daytime average SBP,night average SBP,morning average SBP,24 h average DBP,daytime average diastolic blood pressure,night average diastolic blood pressure,morning average DBP were all decreased,and the observation group had greater decreases in the above parameters than the control group(P<0.05).The RHI,NO and FMD of the observation group were higher than those of the control group[(1.89±0.11)%and(2.25±0.45)%,t=7.810,P<0.05;(63.83±11.56)μmol·L^(-1) and(72.18±12.76)μmol·L^(-1),t=4.873,P<0.05;(7.15±2.03)%与(9.05±1.57)%,t=7.440,P<0.05]and lower levels of ET-1 in the control[(66.13±6.34)%与(50.33±6.43)%,t=17.584,P<0.05].The improvement of vascular elasticity function and cardiac function in the observation group was higher than that in the control(P<0.05).The curative effect of the observation group was better than that of the control(P<0.05).There was no significant difference in the frequency of adverse drug reactions between the 2 groups(P<0.05).Conclusion:Measartan potassium tablet combined with tolvaptan can significantly improve the clinical efficacy,promote the repair of vascular endothelial cell injury and improve the vascular function of patients.
作者
朱培林
张清雯
李小山
ZHU Pei-lin;ZHANG Qing-wen;LI Xiao-shan(Department of Geriatric Cardiology,Jingzhou Second People’s Hospital,Jingzhou 434000,China)
出处
《中国药物应用与监测》
CAS
2023年第6期403-408,共6页
Chinese Journal of Drug Application and Monitoring
基金
湖北省卫生健康委科研项目(WJ2021M081)。
关键词
高血压
心力衰竭
美亚沙坦钾片
托伐普坦
血管功能
血压
High blood pressure
Heart failure
Meixartan potassium tablet
Tolvaptan
Vascular function
Blood pressure
