益气复脉注射液联合美托洛尔治疗原发性高血压伴心力衰竭临床疗效及对心脏重构的影响

The Influence of Yiqi Fumai Injection and Metoprolol in the Treatment of Essential Hypertension with Heart Failure and Its Effects on Cardiac Remodeling

目的观察益气复脉注射液联合美托洛尔治疗原发性高血压伴心力衰竭的疗效及对心脏重构的影响。方法选择2014年8月—2018年8月河南医学高等专科学校附属医院接诊的原发性高血压伴心力衰竭病人76例作为研究对象,以随机数字表法分为观察组(40例)和对照组(36例)。对照组应用美托洛尔治疗,观察组采用益气复脉注射液联合美托洛尔治疗。比较两组治疗后临床疗效、左心室舒张末期内径(LVIDd)、左心室收缩末期内径(LVIDs)、左室射血分数(LVEF)、左心室高峰充盈率(LVPFR)、舒张压、收缩压、N末端脑钠肽前体水平、6 min步行距离及不良反应发生情况。结果治疗后,观察组临床疗效总有效率为97.50%,高于对照组的75.00%(P<0.05);两组治疗前LVIDd、LVIDs、LVEF及LVPFR水平比较差异无统计学意义,治疗后观察组LVIDd、LVIDs低于对照组,LVEF、LVPFR高于对照组(P<0.05);两组治疗前舒张压、收缩压水平比较差异无统计学意义,治疗后,两组舒张压、收缩压水平均明显下降(P<0.05);且观察组舒张压、收缩压水平均低于对照组(P<0.05);两组治疗前N末端脑钠肽前体水平、6 min步行距离比较差异无统计学意义,治疗后,两组N末端脑钠肽前体水平均明显下降,6 min步行距离明显上升,且观察组N末端脑钠肽前体水平低于对照组,6 min步行距离大于对照组(P<0.05);观察组不良反应总发生率为5.00%,对照组不良反应总发生率为8.33%,两组差异无统计学意义(P>0.05)。结论对原发性高血压伴心力衰竭病人采用益气复脉注射液联合美托洛尔治疗临床效果显著,可明显改善病人心脏重构及心功能。

Objective To study the efficacy of Yiqi Fumai injection(YFI)and metoprolol in the treatment of essential hypertension with heart failure and its effects on cardiac remodeling.Methods Seventy-six patients with essential hypertension and heart failure were randomly divided into two groups:the control group(n=36)treated with metoprolol,and the observation group(n=40)treated with YFI and metoprolol.After treatment,the efficacy,left ventricular end diastolic diameter(LVIDd),left ventricular end diastolic diameter(LVIDs),left ventricular ejection fraction(LVEF),left ventricular peak filling rate(LVPFR),diastolic and systolic blood pressure,N-terminal brain natriuretic peptide precursors,walking distance,and adverse reactions were compared between the two groups.Results After treatment,the total effective rate was 97.50%in the observation group,which was higher than that of the control group(75.00%,P<0.05).There was no significant difference in LVIDd,LVIDs,LVEF,and LVPFR between the two groups before treatment.After treatment,LVIDd,and LVIDs of the two groups were significantly decreased,while LVEF and LVPFR were significantly increased.LVIDd,and LVIDs in the observation group were significantly lower than those of the control group,while LVEF and LVPFR were significantly higher than those of the control group(P<0.05).There was no significant difference in diastolic and systolic blood pressure before treatment between the two groups.After treatment,the diastolic blood pressure and systolic blood pressure were significantly decreased in both groups(P<0.05).The diastolic and systolic blood pressure levels of the observation group were lower than those of the control group(P<0.05).There was no significant difference in the level of N-terminal brain natriuretic peptide precursor and the walking distance at 6 min between the two groups.After treatment,the levels of N-terminal brain natriuretic peptide precursors in both groups were significantly decreased,and the walking distance was significantly increased at 6 min,and the level of N-terminal brain natriuretic peptide precursors in the observation group was significantly lower than that in the control group,and the walking distance at 6 min was significantly higher than that in the control group(P<0.05).The total incidence of adverse reactions was 5.00%in the observation group,and that was 8.33%in the control group,and there was no significant difference between two groups(P>0.05).Conclusion YFI and metoprolol can significantly improve cardiac remodeling and cardiac function in patients with essential hypertension and heart failure.