比索洛尔对中年高血压患者并发左心室肥厚的疗效评价
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摘要
目的探讨心超技术评价比索洛尔治疗方案对中年高血压患者并发左心室肥厚的降压疗效,并分析其对左心室肥厚的作用。方法以分层随机抽样抽取高血压并发左心室肥厚患者的病例,根据患者用药情况分为甲组(比索洛尔±氨氯地平)和乙组(氯沙坦±氨氯地平),甲组获得病例483例,乙组获得病例506例,比较治疗前后患者血压、左心室质量指数(LVMI)、左心室射血分数(LVEF)、左心室舒张早期峰值流速/左心室舒张晚期峰值流速(E/A)、二尖瓣环舒张早期运动速度/二尖瓣环舒张晚期运动速度(Em/Am)的变化,并比较甲组和乙组上述指标的差异。结果甲组患者收缩压由(162.6±15.7)mmHg(1 mmHg=0.133 KPa)降至(134.8±13.4)mmHg,舒张压由(95.8±14.6)mmHg降至(85.7±8.2)mmHg,差异均具有统计学意义(均P<0.001);乙组患者收缩压由(165.5±18.9)mmHg降至(136.7±16.2)mmHg,舒张压由(97.4±17.3) mmHg降至(83.5±8.7)mmHg,差异均具有统计学意义(均P<0.001);但甲组与乙组间血压差值治疗前、后均无统计学意义。甲组患者E/A值由(0.70±0.19)升高至(0.87±0.15), Em/Am值由(0.59±0.14)升高至(0.77±0.16);乙组患者E/A值由(0.73±0.18)升高至(0.86±0.14),Em/Am值由(0.63±0.15)升高至(0.79±0.13);差异均具有统计学意义;但甲组与乙组间E/A、Em/Am差别治疗前、后均无统计学意义。两组患者LVEF均呈上升趋势、LVMI均呈下降趋势,但差异均无统计学意义。结论比索洛尔在治疗中年高血压患者左心室肥厚方面的作用与氯沙坦差异无统计学意义,可以作为此类患者治疗的备选方案。
Objective To evaluate the effect of bisoprolol-based therapy on hypertension and left ventricular hypertrophy in middle-aged hypertension patients with left ventricular hypertrophy. Methods Using stratified random sampling, we recruited 45-60 years old hypertension patients complicated with left ventricular hypertrophy and hospitalized in a hospital in Nantong city of Jiangsu province and then divided them into two groups according to their medication regimen: group A(bisoprolol or plus amlodipine, n = 483) and group B(losartan or plus amlodipine, n = 506). Disparities in changes of blood pressure, left ventricular mass index(LVMI), left ventricular ejection fraction(LVEF), early diastolic transmitral velocity/late diastolic transmitral velocity(E/A), and early diastolic tissue velocity/late diastolic tissue velocity(Em/Am) before and after the medication were compared between the two groups. Results For the patients of group A, the systolic blood pressure(SBP) decreased significantly from 162.6 ± 15.7 mmHg to 134.8 ± 13.4 mmHg and the diastolic blood pressure(DBP)decreased significantly from 95.8 ± 14.6 mmHg to 85.7 ± 8.2 mmHg after the medication(both P < 0.001); while, for the patients of group B, the SBP also decreased from 165.5 ± 18.9 mmHg to 136.7 ± 16.2 mmHg and the DBP decreased from97.4 ± 17.3 mmHg to 83.5 ± 8.7 mmHg after the medication, with significant differences(both P < 0.001). But there was no significant differences in blood pressure between the two groups before and after the medication. Compared to those before the medication,the E/A value increased significantly from 0.70 ± 0.19 to 0.87 ± 0.15 for the patients of group A(P = 0.01)and from 0.73 ± 0.18 to 0.86 ± 0.14 for the patients of group B(P = 0.03) after the medication; the Em/Am value also significantly increased from 0.59 ± 0.14 to 0.77 ± 0.16 for the patients of group A(P = 0.01) and 0.63 ± 0.15 to 0.79 ± 0.13 for the patients of group B(P = 0.02) after the medication. There were no significant differences in E/A and Em/Am value between the two groups before and after the medication. Insignificant upward trend in LVEF and downward trend in LVMI were observed. Conclusion There is no statistically significant difference between therapeutic effect of bisoprolol-based and losartan-based medication regimen on left ventricular hypertrophy in middle-aged hypertension patients and the two regimens could be used as alternatives for each other among the patients.
Objective To evaluate the effect of bisoprolol-based therapy on hypertension and left ventricular hypertrophy in middle-aged hypertension patients with left ventricular hypertrophy. Methods Using stratified random sampling, we recruited 45-60 years old hypertension patients complicated with left ventricular hypertrophy and hospitalized in a hospital in Nantong city of Jiangsu province and then divided them into two groups according to their medication regimen: group A(bisoprolol or plus amlodipine, n = 483) and group B(losartan or plus amlodipine, n = 506). Disparities in changes of blood pressure, left ventricular mass index(LVMI), left ventricular ejection fraction(LVEF), early diastolic transmitral velocity/late diastolic transmitral velocity(E/A), and early diastolic tissue velocity/late diastolic tissue velocity(Em/Am) before and after the medication were compared between the two groups. Results For the patients of group A, the systolic blood pressure(SBP) decreased significantly from 162.6 ± 15.7 mmHg to 134.8 ± 13.4 mmHg and the diastolic blood pressure(DBP)decreased significantly from 95.8 ± 14.6 mmHg to 85.7 ± 8.2 mmHg after the medication(both P < 0.001); while, for the patients of group B, the SBP also decreased from 165.5 ± 18.9 mmHg to 136.7 ± 16.2 mmHg and the DBP decreased from97.4 ± 17.3 mmHg to 83.5 ± 8.7 mmHg after the medication, with significant differences(both P < 0.001). But there was no significant differences in blood pressure between the two groups before and after the medication. Compared to those before the medication,the E/A value increased significantly from 0.70 ± 0.19 to 0.87 ± 0.15 for the patients of group A(P = 0.01)and from 0.73 ± 0.18 to 0.86 ± 0.14 for the patients of group B(P = 0.03) after the medication; the Em/Am value also significantly increased from 0.59 ± 0.14 to 0.77 ± 0.16 for the patients of group A(P = 0.01) and 0.63 ± 0.15 to 0.79 ± 0.13 for the patients of group B(P = 0.02) after the medication. There were no significant differences in E/A and Em/Am value between the two groups before and after the medication. Insignificant upward trend in LVEF and downward trend in LVMI were observed. Conclusion There is no statistically significant difference between therapeutic effect of bisoprolol-based and losartan-based medication regimen on left ventricular hypertrophy in middle-aged hypertension patients and the two regimens could be used as alternatives for each other among the patients.
引文
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[8]仉立辉,宫建,杨朋,等.老年女性2型糖尿病患者甲状腺结节超声特征的临床分析[J].中华妇幼临床医学杂志(电子版),2016,12(1):35-39.
[9]冯颖青.高血压合并左心室肥厚--what's news?[J].中华高血压杂志,2017,25(7):616-619.
[10]匡泽民,王瑛,王佳洁,等.比索洛尔干预伴左室肥厚的年轻高血压患者效果研究[J].中国新药杂志,2017, 26(16):1923-1929.
[2]杨事达,宫建,杨传家,等.老年女性高血压患者甲状腺激素水平的初步分析[J].慢性病学杂志,2014, 15(3):201-202.
[3]宫建,杨传家,陈海平,等.老年高血压患者甲状腺激素水平的初步分析[J].河南医学研究,2014,23(12):19-20.
[4]孙宁玲,Jaw-Wen Chen,王继光,等.亚洲高血压合并左心室肥厚诊治专家共识[J].中华高血压杂志,2016, 24(7):619-627.
[5]宫建,郭凤,李翠英,等.预防医学理念在临床药学多维实践考核评价体系构建中的作用[J].中国公共卫生,2016, 32(11):1602-1604.
[6]李丹,宫建,孙晓辉,等.住院高血压患者的药物利用研究[J].中南药学,2017, 15(10):1470-1472.
[7]杨事达,宫建,杨朋,等.高血压老年男性患者甲状腺功能的临床分析[J].中国医学工程,2014, 22(5):11-13.
[8]仉立辉,宫建,杨朋,等.老年女性2型糖尿病患者甲状腺结节超声特征的临床分析[J].中华妇幼临床医学杂志(电子版),2016,12(1):35-39.
[9]冯颖青.高血压合并左心室肥厚--what's news?[J].中华高血压杂志,2017,25(7):616-619.
[10]匡泽民,王瑛,王佳洁,等.比索洛尔干预伴左室肥厚的年轻高血压患者效果研究[J].中国新药杂志,2017, 26(16):1923-1929.