吲达帕胺联合硝苯地平对高血压并冠心病血压、血脂、心功能的影响

Effects of indapamide combined nifedipine on blood pressure,blood lipid and cardiac function in patients with hypertension complicated with coronary heart disease

目的探讨吲达帕胺联合硝苯地平对高血压合并冠心病患者血压、血脂、内皮功能、心功能的影响。方法将170例高血压合并冠心病患者按随机数字法均分为对照组和观察组,两组患者均在治疗前一周停用其他抗压药和抗冠心病药。对照组给予硝苯地平,观察组在对照组基础上加用吲达帕胺。治疗后,比较两组血压[舒张压(DBP)、收缩压(SBP)]、血脂[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]、内皮功能[硫化氢(H2S)、一氧化氮(NO)、血清细胞间粘附分子1(ICAM-1)]、心功能[左室射血分数(LVEF)、心脏指数(CI)、心脏舒张功能指标E/A]、冠心病临床疗效及不良反应。结果治疗后,两组DBP、SBP均显著降低,且观察组明显低于对照组(P <0. 05)。治疗后,两组TG、TC、LDL-C水平降低(P <0. 05),且观察组明显低于对照组(P <0. 05);两组HDL-C水平升高(P <0. 05),且观察组明显高于对照组(P <0. 05)。治疗后,两组H2S、NO水平升高(P <0. 05),且观察组明显高于对照组(P <0. 05);两组ICAM-1水平降低(P <0. 05),且观察组显著高低于对照组(P <0. 05)。治疗后,两组LVEF、CI、E/A均明显上升(P <0. 05),且观察组上升幅度显著高于对照组(P <0. 05)。治疗后,观察组冠心病疗效总有效率为90. 59%,明显高于对照组52. 94%(P <0. 05)。结论吲达帕胺联合硝苯地平可有效改善高血压合并冠心病患者的血压、血脂、内皮功能和心功能,临床效果满意。

Objective To explore the effects of indapamide combined with nifedipine on blood pressure,blood lipid,endothelial function and cardiac function in patients with hypertension complicated with coronary heart disease.Methods 170 patients with hypertension and coronary heart disease were divided into the control group and the observation group by random number method.The two groups were discontinued with other anti CHD drugs one week before the treatment.The control group was given nifedipine,and the observation group was added indapamide on the basis of the control group.After treatment,two groups of blood pressure (DBP,SBP),blood lipid (TG,TC,HDL-C,LDL-C),endothelial function (H 2S,NO,ICAM-1),cardiac function (LVEF,CI,E/A),coronary heart disease and adverse reactions were compared.Results After treatment,DBP and SBP in the two groups were significantly decreased,and the observation group was significantly lower than that of the control group(P<0.05).After treatment,the level of TG,TC and LDL-C decreased(P<0.05) in the two groups,and the observation group was significantly lower than that of the control group(P<0.05),and the level of HDL-C in the two groups increased(P<0.05),and the observation group was significantly higher than that of the control group(P<0.05).After treatment,the level of H 2S and NO in the two groups increased (P<0.05),and the observation group was significantly higher than that of the control group (P<0.05),and the level of ICAM-1 in the two groups was lower (P<0.05),and the observation group was significantly lower than the control group (P<0.05).After treatment,the two groups of LVEF,CI and E/A increased significantly (P<0.05),and the increase in the observation group was significantly higher than that in the control group (P<0.05).After treatment,the total effective rate of coronary heart disease in the observation group was 90.59%,which was significantly higher than that in the control group (52.94%),P<0.05.Conclusion Indapamide combined with nifedipine can effectively improve blood pressure,blood lipid,endothelial function and cardiac function in patients with hypertension and coronary heart disease with better satisfactory.