低分子肝素钠联合缬纱坦、硝酸甘油治疗高血压病合并冠心病心力衰竭的疗效观察

Efficacy Observation of Low Molecular Weight Heparin Combined with Valsartan and Nitroglycerin for Heart Failure Patients with Hypertension and Coronary Disease

目的:观察低分子肝素钠联合缬纱坦、硝酸甘油治疗高血压病合并冠心病心力衰竭患者的临床转归和心功能改善情况。方法:选择于2008年7月-2010年3月在我科住院的高血压病合并冠心病心力衰竭患者120例,随机分为对照组(60例)和治疗组(60例)。对照组给予持续低流量吸氧、抗感染、利尿、扩血管等常规治疗。治疗组在常规治疗基础上加用低分子肝素钠80IU·kg-1,皮下注射,qd;口服缬纱坦80mg,qd;硝酸甘油20mg+5%葡萄糖注射液250mL静脉滴注,qd,每分钟10～25滴。疗程均为14d。结果:2组治疗后比较,治疗组患者喘闷、水肿等症状明显减轻,心功能明显好于对照组(92.5%vs.67.5%)(P<0.05)。结论:应用低分子肝素钠联合缬纱坦、硝酸甘油治疗高血压病合并冠心病心力衰竭,可明显减轻患者的临床症状并改善心功能。

OBJECTIVE：To observe the clinical outcomes and heart function improvements of heart failure patients with hypertension and coronary disease using low molecular weight heparin combined with valsartan and nitroglycerin.METHODS：120 heart failure patients with hypertension and coronary disease in our hospital from Jul.2008 to Mar.2010 were randomly divided into control group and treatment group（60 cases）.Control group was given conventional treatment including low flow inhale oxygen,antibiotics,diuretics,vasodilators.Besides the conventional treatments,the treatment group was given low molecular weight heparin 80 IU·kg-1 qd,oral dose of valsartan 80 mg qd and intravenous drip of nitroglycerin 20 mg and 5% glucose solution 250 mL qd 10～25 gttg·min-1.The treatment course lasted for 14 days.RESULTS：Compared with control group,the heart failure of patients in the treatment group were relieved significantly,and heart function was improved obviously（improvement rate of 92.5%） while the improvement rate of control group was 67.5%（P〈0.05）.CONCLUSION：Low molecular weight heparin combined with valsartan and nitroglycerin could improve clinical symptoms and heart functions in heart failure patients with hypertension and coronary disease.