MHT联合降压药治疗围绝经期高血压患者疗效观察

Effect of menopausal hormone therapy combined with antihypertensive drugs on patients with perimenopausal hypertension

目的观察绝经激素治疗(MHT)与降压药联合治疗围绝经期高血压患者的效果。方法选择2019年2~12月陕西省第四人民医院妇产科收治的86例围绝经期高血压患者为研究对象,按照随机数表法将患者分为观察组和对照组各43例。对照组患者给予比索洛尔治疗,观察组患者在对照组基础上联合芬吗通治疗,疗程均为3个月,比较两组患者的临床疗效,治疗前后的激素水平[血清雌二醇(E2)、促黄体生成素(LH)、卵泡刺激素(FSH)]、血压水平、血管内皮功能[血清血管性血友病因子(VEF),一氧化氮(NO)、内皮素-1(ET-1)]和更年期临床症状调查表(Kupperman)评分。结果观察组患者的治疗总有效率为95.35%,明显高于对照组的79.07%,差异有统计学意义(P<0.05);两组患者治疗前的血压比较差异无统计学意义(P>0.05),治疗后,观察组患者的收缩压为(127.36±10.52)mmHg,明显低于对照组的(138.77±10.13)mmHg,差异有统计学意义(P<0.05),但两组患者治疗后的舒张压比较差异无统计学意义(P>0.05);治疗前,两组患者的Kupperman评分比较差异无统计学意义(P>0.05),治疗后,观察组患者的Kupperman评分为(5.39±1.51)分,明显低于对照组的(13.05±3.36)分,差异有统计学意义(P<0.05);两组患者治疗前的E2、FSH、LH及NO、ET-1、VEF水平比较差异均无统计学意义(P>0.05),治疗后,观察组患者的E2、NO水平分别为(22.37±5.04)mmol、(101.26±6.34)mmol/L,明显高于对照组的(9.89±3.26)mmol、(80.28±7.67)mmol/L,FSH、LH、ET-1、VEF水平分别为(32.34±6.22)IU/L、(23.21±4.52)IU/L、(63.79±6.30)ng/L、(79.51±8.50)%,明显低于对照组的(77.26±8.51)IU/L、(48.67±4.98)IU/L、(89.65±7.23)ng/L、(101.46±18.35)%,差异均有统计学意义(P<0.05)。结论MHT与降压药联合治疗围绝经期高血压可降低患者的收缩压,改善血管内皮功能、激素水平,减轻围绝经期症状,提高治疗有效率,值得临床推广。

Objective To observe the effect of menopausal hormone therapy(MHT)combined with antihypertensive drugs in the treatment of perimenopausal hypertension.Methods Eighty-six patients with perimenopausal hypertension admitted to Department of Obstetrics and Gynecology,the Fourth People’s Hospital of Shaanxi Province from February to December 2019 were selected as the research objects.The patients were randomly divided into an observation group and a control group,with 43 patients in each group.The patients in the control group were treated with bisoprolol,while the patients in the observation group were treated with Fenton on the basis of the treatment in the control group.The course of treatment was 3 months.The clinical efficacy,hormone level[Serum estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)],blood pressure level,vascular endothelial function[serum von Willebrand factor(vEF),nitric oxide(NO),endothelin-1(ET-1)],and Kupperman score of the two groups were compared.Results The total effective rate of the observation group was 95.35%,which was significantly higher than79.07%of the control group(P<0.05).There was no statistically significant difference in blood pressure between the two groups before treatment(P>0.05);after treatment,the systolic blood pressure of the observation group was(127.36±10.52)mmHg,which was significantly lower than(138.77±10.13)mmHg of the control group(P<0.05);however,there was no significant difference in diastolic blood pressure after treatment(P>0.05).Before treatment,there was no significant difference in Kupperman score between the two groups(P>0.05);after treatment,Kupperman score of the observation group was(5.39±1.51)points,significantly lower than(13.05±3.36)points of the control group(P<0.05).E2,FSH,LH,NO,ET-1,VEF of the two groups showed no significant difference before treatment(P>0.05);after treatment,E2,NO level of the observation group were(22.37±5.04)mmol,(101.26±6.34)mmol/L,significantly higher than(9.89±3.26)mmol,(80.28±7.67)mmol/L of the control group;FSH,LH,ET-1,VEF level of the observation group were(32.34±6.22)IU/L,(23.21±4.52)IU/L,(63.79±6.30)ng/L,(79.51±8.50)%,significantly lower than(77.26±8.51)IU/L,(48.67±4.98)IU/L,(89.65±7.23)ng/L,(101.46±18.35)%in the control group(P<0.05).Conclusion The combination of MHT and antihypertensive drugs in the treatment of patients with perimenopausal hypertension can reduce the patients’systolic blood pressure,improve vascular endothelial function,hormone level,relieve the symptoms of perimenopausal period,and improve the treatment efficiency,which is worthy of clinical promotion.