钙通道阻滞剂单用或与ACEI联用治疗Ⅰ-Ⅱ级原发性高血压合并冠心病患者的疗效

Curative effects of calcium channel blocker used singly or combined with ACEI in patients with grade Ⅰ-Ⅱ primary hypertension complicated by coronary heart disease

目的探讨钙通道阻滞剂单用或与血管紧张素转化酶抑制剂(ACEI)联用治疗Ⅰ~Ⅱ级原发性高血压合并冠状动脉粥样硬化性心脏病(冠心病)临床疗效及安全性。方法纳入2013年1月~2014年12月于西安市第一医院收治的Ⅰ~Ⅱ级原发性高血压合并冠心病患者共140例,随机分为对照组(70例)和观察组(70例),分别采用钙通道阻滞剂单用和在此基础上与ACEI联用治疗,比较两组患者临床疗效,治疗前后血压水平、肾脏功能指标水平、心肌缺血事件及不良反应发生率等。结果观察组患者临床疗效显著优于对照组(P<0.05);观察组患者治疗后血压水平和肾脏功能指标水平均显著优于对照组及治疗前(P<0.05);观察组患者心肌缺血事件发生率显著低于对照组(P<0.05);同时两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论相较于钙通道阻滞剂单用,钙通道阻滞剂与ACEI联用治疗Ⅰ~Ⅱ级原发性高血压合并冠心病可有效提高血压控制效果,保护肾脏功能,改善远期预后,且未增加不良反应发生风险。

Objective To investigate the clinical efficacy and safety of calcium channel blocker used singly orcombined with angiotensin converting enzyme inhibitor(ACEI)in patients with gradeⅠ~Ⅱprimary hypertensioncomplicated by coronary heart disease(CHD).Methods The patients(n=140)were chosen from the First Hospitalof Xi’an City from Jan.2013to Dec.2014,and randomly divided into control group and observation group(eachn=70).The control group was given only calcium channel blocker and observation group,calcium channel blockercombining ACEI.The clinical efficacy,blood pressure level,indexes of renal function,and incidence of myocardialischemia events and adverse reactions were compared in2groups before and after treatment.Results The clinicalefficacy was significantly superior in observation group to that in control group(P<0.05).The blood pressure leveland indexes of renal function were significantly superior in observation group to those in control group(P<0.05)aftertreatment.The incidence of myocardial ischemia events was significantly lower in observation group than that incontrol group(P<0.05).The difference in incidence of adverse reactions had no statistical significance between2groups(P>0.05).Conclusion Calcium channel blocker combining ACEI,compared calcium channel blocker usedsingly,can improve blood pressure control effect,protect renal function,ameliorate long-term prognosis and doesnot increase the risk of adverse reactions in patients with gradeⅠ~Ⅱprimary hypertension complicated by CHD.