卡维地洛联合缬沙坦治疗高血压伴室性心律失常患者的效果

Effects of Carvedilol combined with Valsartan in treatment of patients with hypertension and ventricular arrhythmia

目的:观察卡维地洛联合缬沙坦治疗高血压伴室性心律失常患者的效果。方法:选取2021年6月至2023年6月该院收治的80例高血压伴室性心律失常患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各40例。对照组采用缬沙坦治疗,研究组在对照组基础上联合卡维地洛治疗,比较两组临床疗效、治疗前后炎性指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)]水平、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]水平、血管内皮功能指标[内皮素-1(ET-1)、同型半胱氨酸(Hcy)]水平和心率变异性指标[全部窦性RR间期均值的标准差(SDANN)、相邻窦性RR间期差值的均方根(RMSSD)、全部窦性RR间期的标准差(SDNN)]水平。结果:研究组治疗总有效率为90.00%(36/40),高于对照组的72.50%(29/40),差异有统计学意义(P<0.05);治疗后,研究组PCT、CRP和WBC水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组LVEF水平高于对照组,LVESD和LVEDD水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组ET-1、Hcy水平均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组SDANN、RMSSD和SDNN均大于对照组,差异有统计学意义(P<0.05)。结论:卡维地洛联合缬沙坦治疗高血压伴室性心律失常患者可提高治疗总有效率,改善心率变异性指标和心功能指标水平,降低炎性指标和血管内皮功能指标水平,效果优于单纯缬沙坦治疗。

Objective:To observe effects of Carvedilol combined with Valsartan in treatment of patients with hypertension and ventricular arrhythmia.Methods:A prospective study was conducted on 80 patients with hypertension and ventricular arrhythmia admitted to the hospital from June 2021 to June 2023.According to the random number table method,they were divided into control group and study group,40 cases in each group.The control group was treated with Valsartan,while the study group was treated with Carvedilol on the basis of that of the control group.The clinical efficacy,the levels of inflammatory indexes [C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC)],cardiac function indexes [left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD) and left ventricular end-diastolic diameter(LVEDD)],vascular endothelial function indexes [endothelin-1(ET-1),homocysteine(Hcy)] and heart rate variability indexes [standard deviation of the average NN intervals(SDANN),root mean square successive differences between successive R-Rintervals(RMSSD),standard deviation of NN intervals(SDNN)] were compared between the two groups before and after the treatment.Results:The total effective rate of the study group was 90.00%(36/40),which was higher than 72.50%(29/40) of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of PCT,CRP and WBC in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the level of LVEF in the observation group was higher than that in the control group,the levels of LVESD and LVEDD were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of ET-1 and Hcy in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Furth,after the treatment,SDANN,RMSSD and SDNN in the observation group were longer than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Carvedilol combined with Valsartan in the treatment of the patients with hypertension and ventricular arrhythmia can improve the total effective rate of treatment,prolong the heart rate variability index level,improve the levels of cardiac function indexes,reduce the levels of inflammatory indexes and vascular endothelial function indexes.Moreover,it is superior to single Valsartan treatment.