诺欣妥、倍他乐克联合拜新同治疗老年高血压合并慢性心功能不全的临床研究

A Clinical Study on the Treatment of Senile Hypertension Complicated with Chronic Cardiac Insufficiency by Ningroxinto,Betaloc Combined with Nifedipine

目的分析诺欣妥、厄贝沙坦分别联合倍他乐克和拜新同治疗,对高血压合并慢性心功能不全老年患者右心房结构与功能的影响。方法选择本院2021年10月-2022年10月收治的高血压合并慢性心功能不全老年患者180例,按照随机数字表法分为诺欣妥组(给予诺欣妥、倍他乐克、拜新同治疗)与厄贝沙坦组(给予厄贝沙坦、倍他乐克、拜新同治疗),各组90例。比较两组临床疗效及用药安全性,治疗前后血压水平、NT-proBNP水平、心功能(LVEF、TAPSE、右心室侧壁收缩期位移速度、PASP)、右心房结构(RAVlt、RAVIa、RAVIp、RAVpEF、RAVaEF、RAVtEF)变化。结果诺欣妥组治疗显效率(81.11%)高于厄贝沙坦组(66.67%)(P<0.05);但两组总有效率比较,差异无统计学意义(P>0.05);诺欣妥组治疗后SBP、DBP高于厄贝沙坦组,NT-proBNP低于厄贝沙坦组(P<0.05);诺欣妥组治疗后LVEF、TAPSE、右心室侧壁收缩期位移速度、PASP高于厄贝沙坦组(P<0.05);诺欣妥组治疗后RAVlt、RAVIa、RAVIp低于厄贝沙坦组,RAVpEF、RAVaEF、RAVtEF高于厄贝沙坦组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论诺欣妥、厄贝沙坦分别联合倍他乐克、拜新同均可有效治疗高血压合并慢性心功能不全,且安全性高,但诺欣妥更利于改善左心房结构与功能,提高心功能。

Objective To analyze the effects of norfloxacin and irbesartan combined with betaloc and nifedipine respectively on the structure and function of right atrium in elderly patients with hypertension and chronic cardiac insufficiency.Methods A total of 180 elderly patients with hypertension and chronic heart failure admitted to our hospital from October 2021 to October 2022 were selected.According to the random number table method,they were divided into the noxintuo group(treated with noxintuo,betaloc and bayintong)and the irbesartan group(treated with irbesartan,betaloc and bayintong),with 90 patients in each group.The clinical efficacy and drug safety of the two groups were compared.The changes of blood pressure level,NT-proBNP level,cardiac function(LVEF,TAPSE,right ventricular lateral wall systolic displacement velocity,PASP)and right atrial structure(RAVlt,RAVIa,RAVIp,RAVpEF,RAVaEF,RAVtEF)before and after treatment were compared between the two groups.Results The significant effective rate of nuoxintuo group(81.11%)was higher than that of irbesartan group(66.67%)(P<0.05).However,there was no significant difference in the total effective rate between the two groups(P>0.05).After treatment,the SBP and DBP values of the nuoxintuo group were higher than those of the irbesartan group,and the NT-proBNP value was lower than that of the irbesartan group(P<0.05).After treatment,the systolic displacement velocities of LVEF,TAPSE and right ventricular wall,PSAP in the nuoxintuo group were higher than that in the irbesartan group(P<0.05).After treatment,the levels of RAVlt,RAVIa,and RAVIp in the nuoxintuo group were lower than those in the irbesartan group,while the levels of RAVpEF,RAVaEF,and RAVtEF in the nuoxintuo group were higher than those in the irbesartan group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment(P>0.05).Conclusion Nuoxintuo and irbesartan combined with betaloc and nifedipine respectively can effectively treat hypertension combined with chronic cardiac insufficiency,with high safety.However,norgestimate is more conducive to improving the left atrial structure and function,as well as cardiac function.