贝那普利联合螺内酯治疗治疗原发性醛固酮增多症患者高血压的临床疗效

Clinical efficacy of Benazepril Therapy Combined with Spironolactone in the Treatment of Primary Aldosteronism in Patients with Essential Hypertension

目的:探讨贝那普利联合螺内酯治疗原发性醛固酮增多症患者高血压的临床疗效。方法:将96例老年原发性高血压合并心力衰竭(HF)的患者随机分为联合组(A组)与对照组(B组),每组各48例,B组用螺内酯治疗,A组用贝那普利和螺内酯,治疗期间观察各组患者血压、心率及左室射血分数,左室收缩末期内径,左室舒张末期内径,6分钟步行试验等心功能指标,疗程均为6个月。结果:治疗后,A组总有效率(95.83%)显著高于B组(77.08%),P<0.01;治疗后,2组血压及心率均较治疗前降低(均P<0.01),A组降幅较B组更为显著(P<0.01);治疗后,2组心功能指标较治疗前均有不同程度的改善(均P<0.01),A组较B组改善明显(P<0.01);治疗后,2组6min步行试验较治疗前均有改善(均P<0.01),其中A组较B组差异有统计学意义(P<0.01)。结论:贝那普利联合螺内酯治疗原发性醛固酮增多症患者,可产生协同降压效应,显著改善了高血压合并HF患者的心功能。

Objective： To investigate the clinical efficacy of Benazepril combined with spironolactone in the treatment of primary aldosteronism in patients with essential hypertension. Methods： 96 cases of elderly hypertensive patients with heart failure were randomly divided into combined group（group A） and control group（B group）, each group had 48 cases, group B with spironolactone therapy, group A with Benazepril and spironolactone, observed in patients with blood pressure, heart rate and left ventricular ejection fraction during treatment, left ventricular end systolic diameter, left ventricular end diastolic diameter, 6 minutes walk test and other indexes of heart function, the course of treatment was 6 months. Results： After treatment, the total effective rate of group A（95.83%） was significantly higher than that in B group（77.08%）,P〈0.01; after treatment, 2 groups of blood pressure and heart rate were lower than those before treatment（P〈0.01）, A group was compared with that of B group was more significant（P〈0.01）; after treatment, 2 groups of cardiac function index compared with before treatment were improved with different degree（P〈0.01）, in A group than in B group were significantly improved after treatment（P〈0.01）; group, 2 6min walk test was improved compared with that before treatment（P〈0.01）, the difference was statistically significant in A group than in B group（P〈0.01）. Conclusion： Benazepril combined with spironolactone in the treatment of patients with primary aldosteronism, can produce synergistic antihypertensive effect, can significantly improve the heart function of patients with essential hypertension complicated with heart failure.