依普沙坦治疗冠心病合并高血压的临床观察

Clinical Observation of Eprosartan in the Treatment of Hypertensive with Coronary Heart Disease

目的:观察依普沙坦治疗冠心病合并高血压患者的疗效和安全性。方法:160例冠心病合并高血压患者随机均分为观察组和对照组。两组患者均给予阿司匹林、硝酸甘油、低分子肝素、他汀类药物等常规治疗,对照组患者在常规治疗的基础上给予氯沙坦钾片50 mg,口服,每日1次;观察组患者在常规治疗的基础上给予依普沙坦片600 mg,口服,每日1次。两组疗程均为6个月。观察两组患者的临床疗效,治疗前后坐位收缩压、坐位舒张压、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、尿素(UREA)、肌酐(Cr)、尿酸(UA)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、简易精神状态量表(MMSE)评分、日常生活能力量表(ADL)评分及不良反应发生情况。结果:两组患者总有效率比较,差异均无统计学意义(P>0.05)。治疗后,两组患者坐位收缩压、坐位舒张压、MMSE评分、ADL评分均显著低于同组治疗前,且观察组坐位收缩压低于对照组,差异均有统计学意义(P<0.05);两组患者坐位舒张压、MMSE评分、ADL评分组间比较,差异均无统计学意义(P>0.05);两组患者治疗前后ALT、AST、UREA、Cr、UA、TC、TG、HDL-C、LDL-C比较,差异均无统计学意义(P>0.05)。两组患者治疗期间均未见明显不良反应发生。结论:依普沙坦可有效降低冠心病合并高血压患者坐位收缩压,改善认知功能,安全性较好。

OBJECTIVE： To observe the efficacy and safety of eprosartan in the treatment of hypertensive patients with coro- nary heart disease. METHODS： 160 hypertensive patients with coronary heart disease randomly divided into observation group and control group. All patients were given aspirin, nitroglycerin, low molecular weight heparin, statins and other conventional treat- ment; control group was additioanlly given 50 mg Losartan potassium tablet, orally, once a day. Observation group was additional- ly given 600 mg Eprosartan tablet, orally, once a day. The treatment course for both groups was 6 months. Clinical efficacy, sit- ting systolic blood pressure and diastolic blood pressure, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, urea （UREA）, creatinine （Cr）, uric acid （UA）, total cholesterol （TC）, triglyceride （TG）, high-density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （LDL-C）, the Mini-Mental status （MMSE） scale and activities of daily living （ADL） scale scores before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS： There was no signifi- cant difference in the total effective rate between 2 groups （P〉0.05）. After treatment, the sitting systolic blood pressure and diastol- ic blood pressure, MMSE and ADL scale scores in 2 groups were significantly lower than before, and sitting systolic blood pres- sure in observation group was lower than control group, the differences were statistically significant （P〈0.05）, and there were no significant differences in sitting diastolic blood pressure, MMSE and ADL scale scores between 2 groups （P〉0.05）, and no signifi- cant differences in ALT, AST, UREA, Cr, UA, TC, TG, HDL-C and LDL-C between 2 groups before and after treatment （P〉 0.05）. There were no obvious adverse reactions during treatment. CONCLUSIONS： Eprosartan can effectively reduce sitting systol- ic blood pressure in hypertensive patients with coronary heart disease, and improve cognitive function, with good safety.