贝那普利联合辛托伐他汀治疗高血压合并阵发性房颤的疗效及其对患者血清炎症因子水平的影响
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摘要
目的探讨贝那普利联合辛托伐他汀治疗高血压合并阵发性房颤的疗效及其对患者血清炎症因子水平的影响。方法选择深圳市龙华区人民医院心内科于2015年1月至2017年6月期间收治的48例高血压合并阵发性房颤患者为研究对象,根据随机数表法分为对照组和观察组,每组24例,对照组应用非洛地平治疗,观察组予贝那普利联合辛托伐他汀,疗程6个月。比较两组患者的临床疗效及治疗前后的血压、血清超敏C反应蛋白(hs-CRP)和左心房内径(LAD)的变化。结果治疗后,观察组与对照组患者收缩压、舒张压分别为(134.1±8.2) mmHg、(84.6±4.8) mmHg和(135.9±9.8) mmHg、(84.2±5.5) mmHg,均较治疗前显著下降,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05);观察组患者的治疗总有效率为95.83%,明显高于对照组的79.17%,差异有统计学意义(P<0.05);治疗后,观察组患者的血清hs-CRP及LAD水平分别为(6.02±1.38) mg/L、(37.25±4.12) mm,低于对照组的(9.67±3.09) mg/L、(40.87±5.56) mm,差异均有统计学意义(P<0.05)。结论贝那普利联合辛托伐他汀可有效改善高血压合并阵发性房颤患者的心房重构、抑制炎症反应,进而提高临床疗效。
Objective To investigate the effects of benazepril combined with simvastatin in hypertensive patients with paroxysmal atrial fibrillation and its influence on serum inflammatory factors. Methods A total of 48 patients of hypertension with paroxysmal atrial fibrillation treated in Department of Cardiology in Longhua District People's Hospital from January 2015 to June 2017 were selected as the research objects. They were divided into observation and control group according to random number table, with 24 patients in each group. The control group was treated with felodipine treatment, and the observation group was given benazepril combined with simvastatin. The course of treatment was 6 months. The clinical efficacy, changes of serum high-sensitivity C-reactive protein(hs-CRP), and left atrial diameter(LAD) before and after treatment were compared between the two groups. Results After treatment, the systolic pressure and diastolic pressure of the observation group and the control group were(134.1±8.2) mmHg,(84.6 ± 4.8) mmHg,which were significantly lower than(135.9±9.8) mmHg,(84.2±5.5) mmHg before treatment(P<0.05), but there was no significant difference between the two groups(P>0.05). The total effective rate of observation group was 95.83%, which was significantly higher than 79.17% of the control group(P<0.05). After treatment, serum hs-CRP and LAD levels in observation group were(6.02 ±1.38) mg/L,(37.25 ±4.12) mm, respectively, which were lower than(9.67 ±3.09) mg/L,(40.87±5.56) mm in the control group(P<0.05). Conclusion Benazepril combined with simvastatin can effectively improve atrial remodeling and inhibit inflammation in patients with hypertension with paroxysmal atrial fibrillation, thereby improving clinical efficacy.
Objective To investigate the effects of benazepril combined with simvastatin in hypertensive patients with paroxysmal atrial fibrillation and its influence on serum inflammatory factors. Methods A total of 48 patients of hypertension with paroxysmal atrial fibrillation treated in Department of Cardiology in Longhua District People's Hospital from January 2015 to June 2017 were selected as the research objects. They were divided into observation and control group according to random number table, with 24 patients in each group. The control group was treated with felodipine treatment, and the observation group was given benazepril combined with simvastatin. The course of treatment was 6 months. The clinical efficacy, changes of serum high-sensitivity C-reactive protein(hs-CRP), and left atrial diameter(LAD) before and after treatment were compared between the two groups. Results After treatment, the systolic pressure and diastolic pressure of the observation group and the control group were(134.1±8.2) mmHg,(84.6 ± 4.8) mmHg,which were significantly lower than(135.9±9.8) mmHg,(84.2±5.5) mmHg before treatment(P<0.05), but there was no significant difference between the two groups(P>0.05). The total effective rate of observation group was 95.83%, which was significantly higher than 79.17% of the control group(P<0.05). After treatment, serum hs-CRP and LAD levels in observation group were(6.02 ±1.38) mg/L,(37.25 ±4.12) mm, respectively, which were lower than(9.67 ±3.09) mg/L,(40.87±5.56) mm in the control group(P<0.05). Conclusion Benazepril combined with simvastatin can effectively improve atrial remodeling and inhibit inflammation in patients with hypertension with paroxysmal atrial fibrillation, thereby improving clinical efficacy.
引文
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[9]宁伟明,苏新养,卢红艳,等.慢性房颤并发心力衰竭的危险性评价系统的建立[J].海南医学,2016,27(16):2591-2593.
[10]裴芳,黄骥,黄婕,等.胺碘酮联合RAS抑制剂治疗高血压合并阵发性房颤的临床研究[J].重庆医学,2014,43(36):4937-4939.
[11]刘维琴,马清华,牟霞.房颤形成机制与治疗研究进展[J].贵州医药,2012,36(12):1146-1149.
[12]罗伶俐,刘明,曾国良.左房内径和高敏C反应蛋白与房颤的相关性[J].海南医学,2016,27(11):1846-1847.
[13]PSYCHARI SN,APOSTOLOU TS,SINOS L,et al.Relation of elevated C-reactive protein and interleukin-6 levels to left atrial size and duration of episodes in patients with atrial fibrillation[J].Am JCardiol,2005,95(6):764-767.
[14]冯桂兰,马文英,李虹伟.120例心房颤动患者超敏C反应蛋白水平分析[J].中西医结合心脑血管病杂志,2009,7(1):92-93.
[15]余晓峰.辛伐他汀治疗动脉粥样硬化性急性脑梗死的疗效及其对炎症因子的影响[J].中国药业,2013,22(18):20-22.
[16]曹明英,姚朱华,郑权秀,等.强化他汀治疗对ACS患者PCI围手术期胱抑素C和炎症反应的影响[J].中华急诊医学杂志,2014,23(7):761-764.
[2]严冰.阿托伐他汀对慢性心功能不全合并阵发性房颤患者C反应蛋白水平及临床预后的影响[J].中国医刊,2014,49(5):58-60.
[3]阿丽米拉·叶尔波拉提,木胡牙提,卢武红,等.炎症因子的基因多态性对房颤患者的影响研究[J].中华医院感染学杂志,2014,24(6):1311-1313.
[4]刘力生.中国高血压防治指南[J].中华高血压杂志,2011,19(8):701-743.
[5]梁海军.胺碘酮联合缬沙坦治疗老年阵发性房颤患者的疗效[J].中国老年学杂志,2014,34(4):1040-1041.
[6]刘洋,王天策,许日昊,等.心房纤颤外科治疗的现状分析[J].中国老年学杂志,2013,33(5):1231-1235.
[7]林旭辉,陈子凌.血浆脂联素水平与高血压合并阵发性房颤的相关性分析[J].山西医科大学学报,2013,44(8):599-602.
[8]林建珍,林金秀,白萍,等.左心室构型对原发性高血压患者左心功能和房颤影响的分析[J].福建医药杂志,2015,37(2):5-7,23.
[9]宁伟明,苏新养,卢红艳,等.慢性房颤并发心力衰竭的危险性评价系统的建立[J].海南医学,2016,27(16):2591-2593.
[10]裴芳,黄骥,黄婕,等.胺碘酮联合RAS抑制剂治疗高血压合并阵发性房颤的临床研究[J].重庆医学,2014,43(36):4937-4939.
[11]刘维琴,马清华,牟霞.房颤形成机制与治疗研究进展[J].贵州医药,2012,36(12):1146-1149.
[12]罗伶俐,刘明,曾国良.左房内径和高敏C反应蛋白与房颤的相关性[J].海南医学,2016,27(11):1846-1847.
[13]PSYCHARI SN,APOSTOLOU TS,SINOS L,et al.Relation of elevated C-reactive protein and interleukin-6 levels to left atrial size and duration of episodes in patients with atrial fibrillation[J].Am JCardiol,2005,95(6):764-767.
[14]冯桂兰,马文英,李虹伟.120例心房颤动患者超敏C反应蛋白水平分析[J].中西医结合心脑血管病杂志,2009,7(1):92-93.
[15]余晓峰.辛伐他汀治疗动脉粥样硬化性急性脑梗死的疗效及其对炎症因子的影响[J].中国药业,2013,22(18):20-22.
[16]曹明英,姚朱华,郑权秀,等.强化他汀治疗对ACS患者PCI围手术期胱抑素C和炎症反应的影响[J].中华急诊医学杂志,2014,23(7):761-764.