非洛地平缓释片联合美托洛尔治疗原发性高血压合并心力衰竭的效果观察

Effect of felodipine sustained-release tablets combined with metoprolol on patients with essential hypertension and heart failure

目的:观察非洛地平缓释片联合美托洛尔治疗原发性高血压(EH)合并心力衰竭(HF)患者的临床疗效。方法:选取2018年1月至2019年6月漯河市中心医院收治的EH合并HF的患者116例为研究对象,将其随机分为对照组和观察组,每组58例。对照组患者给予美托洛尔片治疗,观察组在对照组的基础上给予非洛地平缓释片治疗,治疗时间为6个月。比较两组患者的临床疗效,并分析血压、血管内皮功能及心功能指标水平变化情况,同时进行6 min步行试验(6MWT),并记录不良反应发生情况。结果:观察组总有效率(82.76%,48/58)高于对照组(63.79%,37/58),差异有统计学意义(χ^2=5.327,P=0.021)。治疗后,两组患者的收缩压、舒张压、血管内皮素1、左心室舒张末期内径、左心室收缩末期内径水平均较治疗前降低,一氧化氮、左心室射血分数、心输出量、6MWT水平均较治疗前升高(P均<0.05),且观察组的上述指标改善更显著(P<0.05)。观察组不良反应发生率(8.62%,5/58)低于对照组(24.14%,14/58),差异有统计学意义(χ^2=5.098,P=0.024)。结论:非洛地平缓释片联合美托洛尔治疗EH合并HF效果显著,能够有效降低血压,改善患者血管内皮功能及心功能,增强患者体力,且安全性高。

Objective:To observe the clinical effects of felodipine sustained-release tablets combined with metoprolol on patients with essential hypertension(EH)and heart failure(HF).Methods:A total of 116 patients with EH and HF treated in Luohe Central Hospital from January 2018 to June 2019 were enrolled as the research subjects.They were randomly divided into control group and observation group,with 58 cases in each group.The control group was treated with metoprolol tablets,while the observation group was additionally given felodipine sustained-release tablets.Both groups were treated for 6 months.The clinical curative effect was compared between the two groups.The changes in blood pressure,vascular endothelial function and cardiac function indexes were analyzed.The 6-minute walking test(6MWT)was conducted.The occurrence of adverse reactions was recorded.Results:The total response rate in observation group(82.76%,48/58)was higher than that in control group(63.79%,37/58),χ^2=5.327,P=0.021.After treatment,the levels of systolic blood pressure,diastolic blood pressure,endothelin-1,left ventricular end-diastolic diameter and left ventricle end-systolic diameter decreased,while the levels of nitric oxide,left ventricular ejection fraction,cardiac output and 6MWT increased in both groups,compared with preoperative levels(P<0.05);and the improvement in these above indexes in observation group was more significant than that in control group(P<0.05).The incidence of adverse reactions in observation group(8.62%,5/58)was significantly lower than that in control group(24.14%,14/58),χ^2=5.098,P=0.024.Conclusions:Felodipine sustained-release tablets combined with metoprolol has significant curative effects in the treatment of EH combined with HF,which can effectively reduce blood pressure,improve vascular endothelial function and cardiac function,enhance physical strength of patients,and has high safety.