硝苯地平联合福辛普利治疗老年冠心病合并高血压

The effect of fosinopril and nifedipine in the treatment of elderly patients with coronary heart disease

目的 探究硝苯地平联合福辛普利应用于老年冠心病(CHD)合并高血压患者对其神经内分泌激素水平及血管内皮因子的改变。方法 选取本院我科2019年3月至2021年2月期间129例老年CHD合并高血压患者作为研究对象,采用抽签法分成两组,对照组64例给予常规硝苯地平单一治疗,观察组65例则在对照组治疗基础上同时接受福辛普利治疗,对比两组患者血压水平、心功能指标、神经内分泌激素水平、血管内皮因子。结果 观察组血压水平低于对照组(p<0.05);观察组6分钟步行试验距离、左心室射血分数高于对照组,且左心室收缩期末内径(LVESD)、左心室舒张期末内径(LVEDD)、B型尿钠肽(BNP)低于对照组(p<0.05);观察组血浆醛固酮(ALD)、血管紧张素Ⅱ(AngⅡ)、肾素(PRA)水平均明显低于对照组(p<0.05);观察组血清血管内皮生长因子(VEGF)水平高于对照组,且内皮素(ET)水平低于对照组(p<0.05)。结论 硝苯地平联合福辛普利治疗老年CHD合并高血压患者,能够改善患者心功能指标、神经内分泌激素水平、血管内皮因子水平。

Objective To explore the changes of neuroendocrine hormone levels and vascular endothelial factor in elderly patients with coronary heart disease(CHD) combined with hypertension. Methods One hundred and twenty nine elderly patients with CHD and hypertension in our department from March 2019 to February 2021 were selected as the research objects, and they were divided into two groups by lottery. Sixty four cases in the control group were given conventional nifedipine monotherapy, and the observation group 65 cases received fosinopril treatment on the basis of the control group. The blood pressure levels, cardiac function indexes,neuroendocrine hormone levels, and vascular endothelial factor were compared between the two groups. Results The blood pressure level of the observation group was lower than that of the control group(p<0.05), the 6-min walk test distance and left ventricular ejection fraction of the observation group were higher than those of the control group, and the left ventricular end systolic inner diameter(LVESD) and left ventricular end diastolic inner diameter( LVEDD) and B-type natriuretic peptide(BNP) were lower than those in the control group(p<0.05).The plasma aldosterone(ALD), angiotensin Ⅱ(Ang Ⅱ) and renin(PRA) levels in the observation group were significantly lower than those in the control group(p<0.05). The serum vascular endothelial growth factor(VEGF)level of the observation group was higher than that of the control group, and the endothelin(ET) level was lower than that of the control group(p <0.05). Conclusions Nifedipine combined with fosinopril in the treatment of elderly CHD patients with hypertension can improve the cardiac function indexes, neuroendocrine hormone levels,and vascular endothelial factor levels.