依那普利和缬沙坦对老年高血压合并心律失常患者室性早搏和QT间期离散度影响

Effect of enalapril and valsartan on ventricular premature beats and QT interval dispersion in elderly patients with hypertension and arrhythmia

目的老年高血压合并心律失常在临床存在较大危害性,而药物治疗较为广泛。本研究探讨依那普利与缬沙坦治疗老年高血压合并心律失常患者血压水平、室性早搏、QT间期离散度(QT interval dispersion,QTcd)效果。方法选取2018-02-01—2019-02-01我院入院诊治的113例老年原发性高血压合并心律失常患者作为研究对象,两组均予常规干预,依那普利组56例患者采用依那普利药物治疗,缬沙坦组患者57例采用缬沙坦治疗,对比两组患者QTcd改善情况,室性早搏及血压水平稳定等情况。结果治疗后,缬沙坦组患者QTc水平为324.11±11.39,低于依那普利组的360.59±14.24,t=15.052,P<0.001;QTcd水平为20.33±4.28,低于依那普利组的30.16±6.48,t=9.531,P<0.001;室性早搏次数为(630.22±60.19)次,低于依那普利组的(884.15±71.50)次,t=20.437,P<0.001。治疗后,依那普利组和缬沙坦组收缩压分别为129.06±11.35和126.78±13.22,差异无统计学意义,t=0.983,P=0.328;依那普利组和缬沙坦组收缩压分别为82.71±6.33和81.11±7.55,差异无统计学意义,t=1.220,P=0.225。结论两种药物对老年高血压合并心律失常患者高血压症状的改善效果相似,但缬沙坦对患者QTcd及室性早搏情况效果更优。

OBJECTIVE Hypertension complicated with arrhythmia in the elderly is more harmful in clinical practice,and drug treatment is more extensive.This study aims to investigate the effect of enalapril and valsartan on blood pressure,ventricular premature beats and QT interval dispersion(QTcd)in elderly patients with hypertension complicated with arrhythmia.METHODS A total of 113 elderly patients with essential hypertension and arrhythmia admitted to our hospital from February 1,2018 to February 1,2019 were selected as the study subjects.Both groups were given routine intervention.56 patients in enalapril group were treated with enalapril,57 patients in valsartan group were treated with valsartan.The improvement of QTcd,ventricular premature beats and stable blood pressure were compared between the two groups.RESULTS After treatment,the QTc level was(324.11±11.39)in the valsartan group,which was lower than that of the enalapril group(360.59±14.24),t=15.052,P<0.001.The QTcd level was(20.33±4.28),lower than that of the enalapril group(30.16±6.48),t=9.531,P<0.001.The number of premature ventricular beats was(630.22±60.19)times,which was lower than that of the enalapril group(884.15±71.50)times,t=20.437,P<0.001.After treatment,the systolic blood pressure of enalapril group and valsartan group were(129.06±11.35)and(126.78±13.22),respectively,the difference was not statistically significant,t=0.983,P=0.328.The systolic blood pressure of the enalapril group and valsartan group were(82.71±6.33)and(81.11±7.55),respectively,and the difference was not statistically significant,t=1.220,P=0.225.CONCLUSION The two drugs have similar effect on the improvement of hypertensive symptoms in elderly hypertensive patients with arrhythmia,but valsartan is more effective on QTcd and ventricular premature beats.