螺内酯联合卡维地洛治疗难治性高血压的临床效果

Clinical effect of Spironolactone combined with Carvedilol in the treatment of refractory hypertension

目的探讨螺内酯联合卡维地洛治疗难治性高血压的临床效果。方法选取2017年1月～2018年8月我院收治的80例难治性高血压患者作为研究对象,随机分为常规组(40例)与研究组(40例),常规组采用卡维地洛治疗,研究组采用卡维地洛联合螺内酯治疗。比较两组的血压、超声心动图情况及临床疗效。结果治疗后两组患者的血压均明显低于治疗前,研究组患者的血压明显低于常规组,差异有统计学意义(P<0.05);治疗后两组患者的左室射血分数均高于治疗前,研究组患者的左室射血分数高于常规组,差异有统计学意义(P<0.05);治疗后两组患者的左室收缩末期内径均小于治疗前,研究组患者的左室收缩末期内径小于常规组,差异有统计学意义(P<0.05);研究组患者治疗后的总有效率显著高于常规组,差异有统计学意义(P<0.05);研究组患者的不良反应总发生率低于常规组,差异有统计学意义(P<0.05)。结论螺内酯联合卡维地洛治疗难治性高血压的效果显著,其不仅可以改善患者血压以及超声心动图指标,且可有效降低患者不良反应的发生情况,值得在本地区基层医院进行推广。

Objective To investigate the clinical effect of Spironolactone combined with Carvedilol in the treatment of refractory hypertension. Methods A total of 80 patients with refractory hypertension admitted in our hospital from January 2017 to August 2018 were selected as the subjects, and randomly divided into routine group (n=40) and study group (n=40). Carvedilol was used in routine group. The study group was treated with Carvedilol combined with Spironolactone. The blood pressure, echocardiography and clinical efficacy were compared between the two groups. Results After treatment, the blood pressure of the two groups were significantly lower than those of the conventional group, and the blood pressure of the study group were significantly lower than that of the conventional group, with statistically significant differences (P<0.05). After treatment, the left ventricular ejection fraction of the two groups was higher than that before treatment, and the left ventricular ejection fraction of the study group was higher than that of the conventional group, with statistically significant differences (P<0.05). After treatment, the inner diameter at the end of left ventricular contraction was smaller than that before treatment in both groups, and the inner diameter at the end of left ventricular contraction in the study group was smaller than that of the conventional group, with statistically significant differences (P<0.05). The total effective rate of the study group was significantly higher than that of the conventional group (P<0.05). The total incidence of adverse reactions in the study group was lower than that in the conventional group, and the difference was statistically significant (P<0.05). Conclusion Spironolactone combined with Carvedilol is effective in the treatment of refractory hypertension. It can not only improve the blood pressure and echocardiographic parameters, but also reduce the incidence of adverse reactions. It is worth popularizing in this area.