托拉塞米联合比索洛尔对原发性高血压合并收缩性心力衰竭患者的影响及不良反应分析

Clinical Efficacy and Adverse Reaction of Torasemide Combined with Bisoprolol in the Treatment of Patients with Essential Hypertension Complicated with Systolic Heart Failure

目的研究托拉塞米联合比索洛尔对原发性高血压合并收缩性心力衰竭患者的影响及不良反应分析。方法选取2016年5月~2018年6月本院收治的134例原发性高血压合并收缩性心力衰竭患者为研究对象,按照随机数表法分组,对照组(托拉塞米治疗)67例、研究组(托拉塞米联合比索洛尔治疗)67例。对比两组治疗前后血压、心功能、生化指标、临床疗效及不良反应发生情况。结果研究组治疗总有效率(95.52%)显著高于对照组(80.60%),差异有统计学意义(P<0.05)。两组治疗前后收缩压、舒张压及24h血压变异值组内比较均有明显差异(P<0.05);治疗后组间比较,研究组收缩压、舒张压及24h血压变异值均明显低于对照组,差异有统计学意义(P<0.05)。治疗前后组内比较,两组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及心率较治疗前明显下降,左室射血分数(LVEF)明显升高,差异有统计学意义(P<0.05);而治疗后组间比较,研究组LVEDD、LVESD及心率明显低于对照组,LVEF明显高于对照组,差异有统计学意义(P<0.05)。组内治疗前后比较,超氧化物歧化酶(SOD)明显升高,丙二醛(MDA)、脑钠肽(BNP)明显下降,差异显著(P<0.05);治疗后组间比较,研究组SOD明显高于对照组,MDA、BNP明显低于对照组,差异有统计学意义(P<0.05)。不良反应发生率(8.96%vs11.94%)比较无明显差异(P>0.05)。结论托拉塞米联合比索洛尔对原发性高血压合并心力衰竭的疗效确切,更有助于改善患者心功能状况,稳定血压,抑制氧化应激,不良反应发生率低,安全性较高。

Objective To study the clinical efficacy of torasemide combined with bisoprolol in the treatment of patients with essential hypertension complicated with systolic heart failure. Methods 134 patients with essential hypertension and systolic heart failure admitted to our hospital from May 2016 to June 2018 were enrolled in the study. According to the random number table method, control group (torasemide treatment) 67 cases and study group (torasemide combined with bisoprolol treatment) 67 cases. Blood pressure cardiac function, biochemical parameters, clinical efficacy and adverse reactions were compared before and after treatment. Results The total effective rate of treatment in the study group (95.52%) was significantly higher than the control group (80.60%), and the difference was statistically significant (P <0.05). Before and after treatment, the systolic blood pressure, diastolic blood pressure and 24 h blood pressure variability were significantly different (P<0.05). After treatment, the systolic blood pressure, diastolic blood pressure and 24 h blood pressure variability of the study group were significantly lower than the control group, the difference was statistically significant (P<0.05). Before and after treatment, the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and heart rate were significantly lower than those before treatment, and left ventricular ejection fraction (LVEF) was significantly increased. The difference was statistically significant (P<0.05). Compared with the control group, the LVEDD, LVESD and heart rate in the study group were significantly lower than those in the control group, and the difference was statistically significant (P<0.05). Compared with before and after treatment, superoxide dismutase (SOD) was significantly increased, malondialdehyde (MDA) and brain natriuretic peptide (BNP) were significantly decreased (P<0.05). After treatment, the SOD of the study group was significantly higher than the control group, and the MDA and BNP were significantly lower than the control group (P<0.05). The incidence of adverse reactions (8.96% vs 11.94%) was not significantly different (P>0.05). Conclusion Torasemide combined with bisoprolol is effective in the treatment of essential hypertension complicated with heart failure. It is also helpful to improve cardiac function, stabilize blood pressure, inhibit oxidative stress, and have low incidence of adverse reactions and higher safety.