替米沙坦与苯磺酸氨氯地平对冠心病合并高血压的血管内皮功能及心肌酶谱的影响

Comparative study on the effects of telmisartan and amlodipine besylate on vascular endothelial function and myocardial enzymes in patients with coronary heart disease and hypertension

目的:探究替米沙坦与苯磺酸氨氯地平治疗冠心病合并高血压的临床疗效及对患者血管内皮功能及心肌酶谱的影响。方法:选取某院收治的冠心病合并高血压患者70例,采用随机数字表法将其分为观察组和对照组,每组35例。观察组给予替米沙坦治疗,对照组给予苯磺酸氨氯地平治疗,观察2组患者治疗前后血压及心功能改善情况,比较2组血清炎症因子[血清基质金属蛋白酶(MMP-9)及血清超敏C反应蛋白(hs-CRP)]、心肌酶谱指标[血清肌酸激酶(CK)、脑钠肽(BNP)、醛固酮(ALD)]水平及不良反应发生情况。结果:治疗后观察组患者收缩压、舒张压、MMP-9及hs-CRP水平均显著优于对照组(P<0.05),对照组CK、ALD及BNP水平低于观察组(P<0.05);2组心功能改善情况比较,差异无统计学意义(P>0.05);2组患者均未发生严重不良反应。结论:替米沙坦治疗冠心病合并高血压患者降压效果及改善血管内皮功能作用优于苯磺酸氨氯地平,苯磺酸氨氯地平改善心肌酶谱作用优于替米沙坦,2组用药方案均能起到显著改善血压和心功能的作用。

Objective:To explore the clinical curative effect of telmisartan and amlodipine besylate on patients with coronary heart disease and hypertension,and their influences on vascular endothelial function and myocardial enzymes.Methods:A total of 70 patients with coronary heart disease and hypertension were enrolled and randomly divided into an observation group(n=35,telmisartan)and a control group group(n=35,amlodipine besylate).The improvement of blood pressure and cardiac function in both groups before and after treatment was observed.The levels of serum inflammatory factors[matrix metalloproteinase-9(MMP-9),high-sensitivity C-reactive protein(hs-CRP)]and myocardial enzymes[serum creatine kinase(CK),brain natriuretic peptide(BNP),and aldosterone(ALD)]were compared between the two groups.The occurrence of adverse reactions in both groups was observed.Results:After the treatment,systolic blood pressure,diastolic blood pressure,MMP-9 and hs-CRP levels in the observation group were significantly better than those in the control group(P<0.05).The levels of CK,ALD and BNP in the control group were significantly lower than those in the observation group(P<0.05).There was no significant difference in the improvement of cardiac function between the two groups(P>0.05).There were no severe adverse reactions in either group.Conclusion:The anti-hypertensive effect of telmisartan is better than that of amlodipine besylate in patients with coronary heart disease and hypertension,which can better improve vascular endothelial function.However,the effect of amlodipine besylate is better than that of telmisartan on improving myocardial enzymes.Both regimens can significantly improve blood pressure and cardiac function.