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目的探讨氨氯地平联合瑞舒伐他汀治疗冠心病合并高血压的疗效及安全性,为冠心病合并高血压的治疗提供依据。方法于2014年1月至2016年1月选取100例冠心病合并高血压患者做为研究对象,按随机数字表法分为联合治疗组51例,给予氨氯地平联合瑞舒伐他汀治疗,对照组49例,单纯给予瑞舒伐他汀治疗。通过观察并记录治疗前后血压变化、生化指标和心功能变化,以及治疗期间不良反应情况,评价氨氯地平联合瑞舒伐他汀治疗冠心病合并高血压的疗效及安全性。用SPSS 17.0统计软件进行数据的分析。结果经氯氨地平和瑞舒伐他汀联合治疗后,联合治疗组患者治疗有效率(92.2%)明显高于对照组(71.4%),差异有统计学意义(P<0.05)。治疗前两组患者血清中一氧化氮(NO)、C反应蛋白(CRP)、同型半胱氨酸(HCY)水平差异均无统计学意义(P>0.05),治疗后两组患者血清中CRP、HCY水平均较治疗前明显下降,血清NO水平明显升高,且联合治疗组效果优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组左室射血分数(LVEF)、室间隔厚度(LVST)、左心室舒张末期内径(LVEDD)和二尖瓣早期和晚期血流峰速度比值(E/A)相比,差异均无统计学意义(P>0.05);治疗后,联合治疗组LVST水平明显降低,LVEDD、LVEF和E/A水平明显升高,差异均有统计学意义(P<0.05)。而对照组治疗前后LVST、LVEDD、LVEF和E/A水平无明显差异。随访3个月期间,联合治疗组不良反应率为17.6%,对照组为10.2%,两组比较,差异无统计学意义(P>0.05)。结论氨氯地平联合瑞舒伐他汀对冠心病合并高血压具有较好的治疗效果,降压效果明显,并能改善心功能,不会增加不良反应风险,值得临床推广使用。
Objective To investigate the efficacy and safety of amlodipine combined with rosuvastatin in the treatment of coronary heart disease complicated with hypertension and provide evidence for the treatment of coronary heart disease complicated with hypertension. Methods From January 2014 to January 2016, 100 CHD patients with hypertension were enrolled in this study. According to random number table, 51 patients were divided into combined treatment group and amlodipine combined with rosuvastatin. Group 49 cases, simply given rosuvastatin treatment. To evaluate the efficacy and safety of amlodipine combined with rosuvastatin in the treatment of coronary heart disease complicated with hypertension by observing and recording the changes of blood pressure, biochemical indexes and cardiac function before and after treatment, and the adverse reactions during treatment. Data analysis with SPSS 17.0 statistical software. Results After the combination of chlortetrazepine and rosuvastatin, the treatment effective rate (92.2%) in the combined treatment group was significantly higher than that in the control group (71.4%), the difference was statistically significant (P <0.05). Serum levels of NO, C-reactive protein (CRP) and homocysteine (HCY) were not significantly different between the two groups before treatment (P> 0.05). After treatment, serum levels of CRP , HCY levels were significantly lower than before treatment, serum NO levels were significantly increased, and the combined treatment group was better than the control group, the difference was statistically significant (P <0.05). Before treatment, the differences in left ventricular ejection fraction (LVEF), interventricular septum thickness (LVST), left ventricular end diastolic diameter (LVEDD) and early and late mitral flow peak velocity ratio (E / A) (P> 0.05). After treatment, the levels of LVST, LVEDD, LVEF and E / A in the combined treatment group were significantly lower than those in the combined treatment group (P <0.05). The control group before and after treatment LVST, LVEDD, LVEF and E / A levels no significant difference. The rate of adverse reactions was 17.6% in the combined treatment group and 10.2% in the control group during the three months follow-up. There was no significant difference between the two groups (P> 0.05). Conclusion Combination of amlodipine and rosuvastatin has good curative effect on patients with coronary heart disease and hypertension. The antihypertensive effect is obvious and the heart function can be improved without increasing the risk of adverse reactions. It is worth to be used clinically.