吲达帕胺联合厄贝沙坦对高血压并发充血性心力衰竭患者的疗效及凝血-纤溶系统的影响

Efficacy of indapamide combined with irbesartan on patients with hypertension complicated with congestive heart failure and its effects on coagulation fibrinolysis system

目的探讨吲达帕胺联合厄贝沙坦对高血压并发充血性心力衰竭(CHF)患者的疗效及凝血-纤溶系统的影响。方法纳入2018年10月~2019年10月我院86例高血压并发CHF患者将其随机分为对照组和观察组,每组各43例。对照组给予厄贝沙坦治疗,观察组基于以上加予吲达帕胺片治疗。对比两组治疗前及治疗3个月后的血压水平和心功能情况,评估两组临床疗效,比较治疗前及治疗3个月后的血小板标志物和血浆凝血-纤溶系统指标水平。结果治疗3个月,两组患者的收缩压(SBP)、舒张压(DBP)、左心室舒张期内径(LVEDD)、左室收缩末期内径(LVESD)值较治疗前显著降低(P<0.05),左室射血分数(LVEF)值较治疗前显著增加(P<0.05),观察组显著高于对照组(P<0.05);观察组的临床总有效率显著高于对照组(P<0.05);治疗3个月,两组患者的血小板糖蛋白Ⅱb/Ⅲa受体(PAC-1)、P-选择素(CD62P)水平相比治疗前有显著降低(P<0.05),两组患者的血浆D-D、纤维蛋白原(FIB)、纤溶酶原激活抑制物-1(PAI-1)水平相比治疗前有显著降低,血浆组织型纤溶酶原激活物(t-PA)相比治疗前有显著升高(均P<0.05),以上指标观察组的变化幅度显著大于对照组(P<0.05)。结论吲达帕胺片联合厄贝沙坦治疗能提高高血压并发CHF患者的临床疗效,有效改善患者的血压水平和心功能,且对血小板PAC-1、CD62P有明显抑制作用,并改善凝血-纤溶系统指标。

Objective To investigate the efficacy of indapamide combined with irbesartan on patients with hypertension complicated with congestive heart failure(CHF)and its effects on coagulation fibrinolysis system.Methods 86 patients with hypertension and CHF were selected and randomly grouped,including 43 cases in control group and 43 cases in observation group.Control group was treated with irbesartan,and observation group was treated with indapamide tablets on this basis.The blood pressure level and cardiac function were compared between the two groups before treatment and after 3 months of treatment,and the clinical efficacy of the two groups was evaluated,and the levels of platelet markers and plasma coagulation-fibrinolysis system indexes were compared before treatment and after 3 months of treatment.Results After 3 months of treatment,the systolic blood pressure(SBP),diastolic blood pressure(DBP),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)in the two groups were significantly decreased compared with those before treatment(P<0.05),while the left ventricular ejection fraction(LVEF)was significantly increased compared with that before treatment(P<0.05).The indexes in observation group were significantly higher than those in control group(P<0.05).The total clinical effective rate in observation group was significantly higher than that in control group(95.35%vs 79.07%,P<0.05).After 3 months of treatment,the levels of platelet glycoproteinⅡb/Ⅲa receptor(PAC-1)and P-selectin(CD62P)in the two groups were significantly decreased compared with those before treatment(P<0.05).The levels of plasma D-D,fibrinogen(FIB)and plasminogen activation inhibitor-1(PAI-1)in the two groups were significantly decreased compared with those before treatment while the plasma tissue-type plasminogen activator(t-PA)was significantly increased compared with that before treatment(P<0.05).The changes of the above indexes in observation group were significantly greater than those in control group(P<0.05).Conclusion Indapamide tablets combined with irbesartan can improve the clinical efficacy of hypertension with CHF,the blood pressure level and cardiac function of patients,and can significantly inhibit the levels of platelet PAC-1 and CD62P,and improve the coagulation-fibrinolysis system indexes.