硝苯地平缓释片联合依那普利在治疗高血压合并冠心病的效果观察

Effect observation of Nifedipine sustained-release tablets combined with Enalapril in the treatment of hypertension complicated with coronary heart disease

目的探讨硝苯地平缓释片联合依那普利在高血压合并冠心病患者中的临床效果。方法选择2018年6月至2020年2月高血压合并冠心病患者132例为对象,随机数字表法分为2组,各66例。对照组采用硝苯地平缓释片治疗,观察组在对照组基础上联合依那普利治疗,治疗4周后对患者效果进行评估,比较2组血压水平、氧化应激水平、心功能、内皮舒张功能及药物不良反应发生率。结果2组治疗后4周收缩压(SBP)、舒张压(DBP)、丙二醛(MDA)及蛋白氧化产物(AOPP)水平均低于治疗前(P<0.05);SOD水平高于治疗前(P<0.05);观察组治疗后4周SBP、DBP、MDA及AOPP水平均低于对照组(P<0.05);SOD水平高于对照组(P<0.05);2组治疗后4周左心室射血分数(LVEF)水平高于治疗前(P<0.05);左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、内皮非依赖性舒张功能(NEDD)及内皮依赖性舒张功能(EDD)水平低于治疗前(P<0.05);观察组治疗后4周LVEF水平高于对照组(P<0.05);LVESD、LVEDD、NEDD及EDD水平低于对照组(P<0.05);2组治疗用药期间恶心呕吐、腹泻便秘、皮疹过敏、肝肾异常及头晕嗜睡发生率差异无统计学意义(P>0.05)。结论硝苯地平缓释片联合依那普利用于高血压合并冠心病患者中能降低患者血压水平,改善氧化应激反应,提升患者心功能水平,亦可改善患者内皮舒张功能,且未增加药物不良反应发生率,值得推广应用。

Objective To investigate the clinical effect of Nifedipine sustained release tablets combined with Enalapril in patients with hypertension complicated with coronary heart disease.Methods A total of 132 patients with hypertension complicated with coronary heart disease from June 2018 to February 2020 were selected and evenly divided into two groups(control group and observation group,n=66)by random number table method.The patients in control group were treated with Nifedipine sustained release tablets,and the ones in observation group were treated with Enalapril on the basis of the control group.After 4 weeks of treatment,the indicators reflecting the clinical treatment effect,including blood pressure,oxidative stress level,cardiac function,endothelial diastolic function,and the incidence of adverse drug reactions were evaluated,and the differences of these indexes between the two groups were compared.Results After treatment,the levels of systolic blood pressure(SBP),diastolic blood pressure(DBP),malonaldehyde(MDA)and adanced oxidation protein products(AOPP)were declined,and the level of superoxide dismutase(SOD)were elevated in both two groups(P<0.05).The levels of SBP,DBP,MDA and AOPP in observation group were lower than those in control group,while SOD level was higher(P<0.05).The level of left ventricular ejection fraction(LVEF)at 4 weeks after treatment was higher than that before treatment,whereas the levels of left ventricular end systolic diameter(LVESD),left ventricular end-diastolic dimension(LVEDD),endothelial independent diastolic function(NEDD)and endothelium-dependent diastolic function(EDD)were lower than those before treatment(P<0.05).The level of LVEF in observation group was higher,and the levels of LVESD,LVEDD,NEDD and EDD were lower than those in the control group at 4 weeks after treatment(P<0.05).There was no statistical significance in the incidence rate of adverse reaction,including nausea and vomiting,diarrhea and constipation,allergic rash,abnormal of hepatic and renal function,dizziness and drowsiness between the two groups(P>0.05).Conclusion Nifedipine sustained release tablets combined with Enalapril has shown promise in the treatment of patients with hypertension and coronary heart disease by reducing blood pressure,improving oxidative stress response,cardiac function,and endothelial relaxation function,as well as it did not increase the incidence rate of adverse drug reactions,which is worthy of promotion and application.