冠心宁片联合吲达帕胺对高血压伴冠心病患者的疗效观察

doi:10.11958/20253569

摘要/Abstract

摘要：

目的观察冠心宁片联合吲达帕胺治疗高血压伴冠心病的效果及对患者的血浆循环内皮细胞（CEC）数量和血清能量平衡蛋白（Adropin）水平的影响。方法纳入150例高血压伴冠心病患者，按随机数字表法分为单用组和联合组，各75例。单用组给予吲达帕胺缓释片，联合组加用冠心宁片，观察疗效、血压、心功能指标、内皮相关指标、血液流变学、血脂指标、炎症指标、Adropin变化。结果联合组总有效率高于单用组（P<0.05）；治疗后2组的收缩压（SBP）、舒张压（DBP）、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）、内皮素-1（ET-1）、CEC、血细胞比容（HCT）、血浆黏度（PV）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、高敏C反应蛋白（hs-CRP）较其治疗前均降低，且联合组低于单用组（P<0.05）；治疗后2组的左室射血分数（LVEF）、一氧化氮（NO）、Adropin较其治疗前升高，且联合组高于单用组（P<0.05）；2组不良反应发生率差异无统计学意义（P>0.05）。结论冠心宁片联合吲达帕胺治疗高血压伴冠心病疗效理想，可显著改善患者CEC和Adropin水平。

关键词: 高血压, 冠心病, 吲达帕胺, 内皮细胞, 冠心宁片, Adropin

Abstract:

Objective To observe the effect of guanxinning tablets combined with indapamide in the treatment of hypertension with coronary heart disease, as well as its influences on the number of plasma circulating endothelial cells (CEC) and the serum level of energy balance protein Adropin in patients. Methods Totally 150 patients with hypertension and coronary heart disease were randomly assigned into the single-use group (indapamide sustained-release tablets) and the combined group (indapamide sustained-release tablets + guanxinning tablets) by random number table method, with 75 cases per group. The therapeutic effect, blood pressure, cardiac function indicators, endothelium-related indicators, hemorheology, lipid indicators, inflammatory indicators and changes in Adropin were observed and compared between the two groups. Results The total effective rate of the combined group was higher than that of the single-use group (P<0.05). After medication, the systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), endothelin-1 (ET-1), CEC, hematocrit (HCT), plasma viscosity (PV), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) were lower than those before medication in both groups, and the combined group was lower than the single-use group (P<0.05). After medication, the left ventricular ejection fraction (LVEF), nitric oxide (NO) and Adropin increased compared with those before medication in both groups, and the combined group was higher than the single-use group (P<0.05). There was no manifest difference in untoward reactions between the single-use group and the combined group during treatment (P>0.05). Conclusion Guanxinning tablets combined with indapamide have an ideal therapeutic effect on hypertension with coronary heart disease, and which can conspicuously improve the levels of CEC and Adropin in patients.

Key words: hypertension, coronary disease, Indapamide, endothelial cells, guanxinning tablets, Adropin

中图分类号:

R544.1

图/表 7

参考文献 26

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组别	性别				年龄/岁		体质量指数/（kg/m²）		病程/年		心功能分级			高血压分级^[13]
组别	男		女		年龄/岁		体质量指数/（kg/m²）		病程/年		Ⅰ级		Ⅱ级	1级		2级
单用组	37（49.33）		38（50.67）		60.35±6.35		22.39±2.17		7.16±2.01		42（56.00）		33（44.00）	44（58.67）		31（41.33）
联合组	35（46.47）		40（53.33）		61.57±5.28		22.07±2.83		7.65±2.31		45（60.00）		30（40.00）	42（56.00）		33（44.00）
t或χ²	0.107				1.287		0.803		1.396		0.246			0.109
组别		合并用药史						冠脉病变				空腹血糖/（mmol/L）			糖化血红蛋白/%
组别		他汀类		β受体阻滞剂		ACEI/ARB类		单支		多支		空腹血糖/（mmol/L）			糖化血红蛋白/%
单用组		38（50.67）		41（54.67）		44（58.67）		28（37.33）		47（62.67）		5.82±0.71			5.65±0.43
联合组		35（46.67）		39（52.00）		46（61.33）		26（34.67）		49（65.33）		5.79±0.68			5.71±0.39
χ²		0.240		0.107		0.111		1.291				0.262			1.049

组别	性别				年龄/岁		体质量指数/（kg/m²）		病程/年		心功能分级			高血压分级^[13]
组别	男		女		年龄/岁		体质量指数/（kg/m²）		病程/年		Ⅰ级		Ⅱ级	1级		2级
单用组	37（49.33）		38（50.67）		60.35±6.35		22.39±2.17		7.16±2.01		42（56.00）		33（44.00）	44（58.67）		31（41.33）
联合组	35（46.47）		40（53.33）		61.57±5.28		22.07±2.83		7.65±2.31		45（60.00）		30（40.00）	42（56.00）		33（44.00）
t或χ²	0.107				1.287		0.803		1.396		0.246			0.109
组别		合并用药史						冠脉病变				空腹血糖/（mmol/L）			糖化血红蛋白/%
组别		他汀类		β受体阻滞剂		ACEI/ARB类		单支		多支		空腹血糖/（mmol/L）			糖化血红蛋白/%
单用组		38（50.67）		41（54.67）		44（58.67）		28（37.33）		47（62.67）		5.82±0.71			5.65±0.43
联合组		35（46.67）		39（52.00）		46（61.33）		26（34.67）		49（65.33）		5.79±0.68			5.71±0.39
χ²		0.240		0.107		0.111		1.291				0.262			1.049

项目	显效	有效	无效
临床症状	消失	改善	明显
心绞痛、眩晕发作次数	减少≥80%	减少≥50%，<80%	未达上述标准
舒张压	降低>20 mmHg或正常	降低10~20 mmHg
硝酸甘油用量	减少≥80%	减少50%~79%
SAQ评分	≥80分	60~79分	<60分

项目	显效	有效	无效
临床症状	消失	改善	明显
心绞痛、眩晕发作次数	减少≥80%	减少≥50%，<80%	未达上述标准
舒张压	降低>20 mmHg或正常	降低10~20 mmHg
硝酸甘油用量	减少≥80%	减少50%~79%
SAQ评分	≥80分	60~79分	<60分

组别	显效/例	有效/例	无效/例	总有效率/%
单用组	26	30	19	74.67
联合组	32	37	6	92.00
χ²				8.112^＊＊