依普沙坦治疗冠心病合并高血压的临床疗效及对坐位收缩压的影响

Therapeutic effect of epusartan on coronaryheart disease complicated hypertension and its influence on mean sitting systolic blood pressure

目的:研究依普沙坦治疗冠心病(CHD)合并高血压的临床疗效及对坐位收缩压(MSSBP)的影响。方法:选择我院收治的CHD合并高血压患者218例,依据随机数字表法分为依普沙坦组(110例)与氯沙坦组(108例)。两组均在常规治疗基础上给予相应药物。治疗6个月,观察两组治疗前后血脂、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)等生化指标,坐位舒张压(MSDBP)、MSSBP,全血黏度低切(WBLSV)、全血黏度高切(WBHSV)、全浆黏度(PV)、红细胞聚集指数(EAI)等血液流变学指标,疗效及不良反应等的变化。结果:治疗前后,两组血脂、AST、ALT组间、组内差异均无统计学意义(P均>0.05)。治疗后,与氯沙坦组比较,依普沙坦组MSSBP[(131.75±13.52)mmHg比(117.95±11.83)mmHg]及WBLSV[(10.98±1.27)mPa·s比(10.21±1.13)mPa·s]、WBHSV[(4.99±0.52)mPa·s比(4.56±0.45)mPa·s]、PV[(2.01±0.34)mPa·s比(1.70±0.26)mPa·s]、EAI[(8.59±0.92)%比(8.02±0.83)%]水平均明显降低(P均=0.001)。依普沙坦组总有效率明显高于氯沙坦组(98.18%比86.11%,P=0.001)。结论:依普沙坦治疗冠心病联合高血压患者可显著降低坐位收缩压,改善血液流变学指标,疗效显著,值得临床应用。

Objective： To study therapeutic effect of epusartan on coronary heart disease （CHD） complicated hypertension and its influence on mean sitting systolic blood pressure （MSSBP）. Methods： A total of 218 CHD patients with hypertension treated in our hospital were selected. They were randomly divided into losartan group （n = 108, received losartan based on routine treatment） and epusartan group （n = 110, received epusartan based on routine treatment）, both groups were treated for six months. Levels of blood lipids, aspartate transaminase （AST） and alanine transaminase （ALT）, mean sitting dias- tolic blood pressure （MSDBP）, MSSBP, whole blood low shear viscosity （WBLSV）, whole blood high shear viscosity （WBHSV）, plasma viscosity （PV） and erythrocyte aggregation index （EAI） before and after treatment, therapeutic effect and incidence of adverse reactions were measured and compared between two groups. Results i There were no significant difference in levels of blood lipids, AST and ALT between two groups before and after treatment, and between before and after treatment, P〉0. 05 all. Compared with losartan group after treatment, there were significant reductions in levels of MSSBP [（131.75 ± 13.52） mmHg vs. （117. 95 ± 11.83） mmHg], WBLSV [（10. 98 ± 1.27） mPa s vs. （10.21 ± 1.13） mPa s], WBHSV [ （4. 99 ± 0. 52） mPa s vs. （4. 56± 0.45） mPa s], PV [ （2. 01± 0.34） mPa s vs. （1.70±0. 26） mPa s] and EAI [（8. 59 ± 0. 92）% vs. （8. 02 ± 0.83）%] in epusartan group, P = 0. 001 all. Total effective rate of epusartan group was significantly higher than that of losartan group （98. 18% vs. 86. 11%, P = 0. 001）. Conclusion： Epusartan can significantly reduce MSSBP, improve hemorheological indexes with significant therapeutic effect in patients with coronary heart disease complicated hypertension, which is worth application in clinic.