论文部分内容阅读
目的对比观察厄贝沙坦氢氯噻嗪与富马酸比索洛尔治疗青年原发性高血压的临床疗效。方法采用随机、平行对照的研究方法,选择青年原发性高血压患者240例,随机分为厄贝沙坦氢氯噻嗪组、富马酸比索洛尔组和联合用药组,每组分别用药4周。观察治疗前后诊室血压、动态血压、心率、心脏结构和功能的变化。结果从治疗第2周开始3组血压均有所下降,在治疗4周末下降最明显;其中厄贝沙坦氢氯噻嗪组收缩压降低较为明显,富马酸比索洛尔组舒张压降低较为明显,联合用药组收缩压和舒张压降低均较显著(均P<0.05);联合用药组与其他两组比较血压明显降低(P<0.05)。富马酸比索洛尔组和联合用药组心率均在正常范围内降低,厄贝沙坦氢氯噻嗪组心率下降不明显。在心脏结构方面,联合用药组左心室舒张末内径(LVIDd)和左心室质量指数(LVMI)较治疗前减小,厄贝沙坦氢氯噻嗪组LVMI也较治疗前减少。在心脏功能方面,联合用药组A峰降低、E峰升高(均P<0.05)。治疗前后24h平均收缩压压差和白昼平均收缩压压差与LVMI轻度相关(分别为r=0.203,P=0.025和r=0.189,P=0.034)。结论厄贝沙坦氢氯噻嗪和富马酸比索洛尔治疗青年高血压患者均具有良好的降血压作用,两者联合有协同效应。
Objective To compare the clinical efficacy of irbesartan hydrochlorothiazide and bisoprolol fumarate in the treatment of young patients with essential hypertension. Methods 240 patients with essential hypertension were randomly divided into irbesartan hydrochlorothiazide group, bisoprolol fumarate group and combination group, and each group was treated for 4 weeks. Observe the changes of clinic blood pressure, ambulatory blood pressure, heart rate, heart structure and function before and after treatment. Results The blood pressure of the three groups decreased from the second week of treatment, and decreased most obviously at the end of the fourth week. Among them, the systolic blood pressure decreased significantly in irbesartan hydrochlorothiazide group and the diastolic blood pressure decreased significantly in bisoprolol fumarate group The systolic blood pressure and diastolic blood pressure in the treatment group were significantly lower than those in the other two groups (all P <0.05). Compared with the other two groups, the blood pressure of the combination group was significantly lower (P <0.05). The heart rate of bisoprolol fumarate group and combination group decreased within the normal range, and the heart rate of irbesartan hydrochlorothiazide group did not decrease obviously. In terms of cardiac structure, left ventricular end-diastolic diameter (LVIDd) and left ventricular mass index (LVMI) in combination group decreased compared with that before treatment, and LVMI in irbesartan-hydrochlorothiazide group also decreased compared with that before treatment. In terms of cardiac function, A group peak decreased, E peak increased (all P <0.05). Mean systolic blood pressure and mean systolic blood pressure at 24 h before and after treatment were slightly associated with LVMI (r = 0.203, P = 0.025 and r = 0.189, P = 0.034, respectively). Conclusion Irbesartan hydrochlorothiazide and bisoprolol fumarate treatment of young patients with hypertension have good antihypertensive effect, the two combined with a synergistic effect.