贝那普利联合卡维地洛治疗原发性高血压患者临床疗效观察

摘要

目的观察贝那普利联合卡维地洛治疗原发性高血压患者的疗效及对心肌肥厚的影响。方法将90例原发性高血压患者随机分为观察组和对照组,观察组用贝那普利加卡维地洛；对照组单用贝那普利。两组疗程均为12月。治疗期间监测血压、空腹血糖、血脂、血钾、血尿酸、尿素氮和肌酐等,观察药物的安全性。结果观察组50例，有效率92%(46/50),血浆血管紧张素Ⅱ(AngⅡ)和醛固酮(Ald)水平明显下降(<0.01)。22例伴有心肌肥厚患者，室间隔厚度( IVST)及左室后壁厚度(LVPWT)、左室舒张末期内径(LVEDd)、左室重量指数(LVMI)明显下降(<0.05)；对照组40例,有效率77.5%(31/40),显著低于观察组(<0.05),对照组AngⅡ和Ald水平有所下降(<0.05)，16例心肌肥厚的患者,超声心动图指标有下降趋势，但无统计学差异(>0.05)；两组治疗前后空腹血糖、血脂、肾功能及电解质无显著变化(>0.05)。结论贝那普利联合卡维地洛治疗原发性高血压患者可安全有效降压,逆转心肌肥厚；改善左室功能。且耐受性好,副作用少,而且对代谢无明显的影响，值得在临床上推广应用。%Objective To approach the curative ef ect of combine reatment of benazepril and carvedilol and its impact on myocardial hypertrophy in patients with essential hypertension.Methods Ninety hypertensive patients were randomly designed to observation group and control group, the observation group (n=50),which were treated with benazepril and carvedilol, and the control group (n=40), which received treatment with only benazepril. the treating course was 12 months for both groups, Blood pressure、blood glucose、blood fat、serum potassium、blood uricacid、urea nitrogen and creatinine and the safety of drugs were examined. Results After treatment the response rate was 92% in the observation group(n=50), the Serum concentrations of Angl and Ald were significantly decreased ( <0.01);Interventricular septal thickness (IVST) and left ventricular posterior wal thickness (LVPWT), Left ventricular end diastolic diameter (LVEDd),left ventricular mass index (LVMI) were decreased significantly ( <0.05) in 26 patients with cardiac hypertrophy ( <0.05) ;the response rate was 77.5% in the control group, group (n=40), the response rate was significantly lower than that of the observation group, the Serum concentrations of Angl and Ald were sensibly decined( <0.05);The incidence of Doppler echocardiography become lower in 16 atients with cardiac hypertrophy ( < 0.05),but the dif erence was not significant in Statistics ( >0.05 );Fasting blood-glucose, blood fat, renal function and electrolytes had no significant change before and after treatment in dif erent groups.Conclusion Benazepril combined with carvedilol is capable of Safe and ef ective antihypertension,reversing left ventricular hypertrophy and improving cardiac function, it had wel tolerance,lower adverse reactions and no perceptible ef ect on metabolism ,wich should be widely spreaded in clinics should be widely spreaded in clinics.