替米沙坦联合β受体阻滞剂、血管紧张素转换酶抑制剂类药物治疗急性心肌梗死伴高血压的效果

Effect of Telmisartan combined with β-blockers and angiotensin converting enzyme inhibitors drugs in the treatment of acute myocardial infarction with hypertension

目的探讨替米沙坦联合β受体阻滞剂及血管紧张素转换酶抑制剂类药物治疗急性心肌梗死伴高血压患者的效果及对患者血压水平和左心室功能的影响,旨在为临床治疗急性心肌梗死伴高血压患者提供用药指导。方法选取2019年1月至2021年6月于黑龙江省医院治疗的85例急性心肌梗死伴高血压患者作为研究对象进行回顾性分析,按照治疗方案的不同将其分为替米沙坦组(41例)和常规治疗组(44例)。替米沙坦组患者应用替米沙坦、β受体阻滞剂和血管紧张素转换酶抑制剂类药物进行治疗;常规治疗组患者应用β受体阻滞剂和血管紧张素转换酶抑制剂类药物进行治疗。比较两组患者治疗前后的血压、左心室舒张末期内径、左心室收缩末期内径、左心室射血分数、血清B型钠尿肽水平的变化情况。结果治疗后,替米沙坦组患者的血压、左心室收缩末期内径、B型钠尿肽低于常规治疗组,差异有统计学意义(P<0.05);治疗后,替米沙坦组患者的左心室射血分数高于常规治疗组,差异有统计学意义(P<0.05);治疗后,替米沙坦组患者的左心室舒张末期内径与常规治疗组比较,差异无统计学意义(P>0.05)。结论替米沙坦联合β受体阻滞剂和血管紧张素转换酶抑制剂类药物,能明显改善急性心肌梗死伴高血压患者的血压水平,并能有效调节其左心室功能。

Objective To explore the effect of Telmisartan combined with β-blockers and angiotensin converting enzyme inhibitors drugs in the treatment of patients with acute myocardial infarction with hypertension,and to provide medication guidance for patients with acute myocardial infarction accompanied by hypertension.Methods A total of 85 patients with acute myocardial infarction with hypertension treated in Heilongjiang Provincial Hospital from January 2019 to June 2021 were selected as the study objects for retrospective analysis,and were divided into Telmisartan group(41 cases)and conventional treatment group(44 cases)according to different treatment regiments.Telmisartan group was treated with Telmisartan,β-blockers and angiotensin converting enzyme inhibitors drugs.Patients in the conventional treatment group were treated with β-blockers and angiotensin-converting enzyme inhibitors drugs.The changes of blood pressure,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction and serum type B natriuretic peptide were compared between the two groups before and after treatment.Results After treatment,blood pressure,left ventricular end-systolic diameter and type B natriuretic peptide in Telmisartan group were lower than those in conventional treatment group,the differences were statistically significant(P<0.05).After treatment,the left ventricular ejection fraction of Telmisartan group was higher than that of conventional treatment group,and the difference was statistically significant(P<0.05).After treatment,there was no significant difference in left ventricular end-diastolic diameter between Telmisartan group and conventional treatment group(P>0.05).Conclusion The combination of Telmisartan,β-receptor blockers and angiotensin converting enzyme inhibitors drugs can significantly improve blood pressure and effectively regulate left ventricular function in hypertensive patients with acute myocardial infarction.