缬沙坦氢氯噻嗪分散片和美托洛尔缓释片联用对高血压左室舒张功能减退的疗效观察

目的 观察缬沙坦氢氯噻嗪分散片联合美托洛尔缓释片对高血压合并左室舒张功能减退的临床疗效.方法 将惠州市惠阳区人民医院2011年5月～2012年5月收治的高血压合并左室舒张功能减退患者110例随机分为两组,每组各55例,对照组单用缬沙坦氢氯噻嗪分散片,观察组在此基础上联合美托洛尔缓释片,比较两组患者临床治疗效果.结果 观察组总有效率为92.73％,明显高于对照组的78.18％,差异有统计学意义（x2=5.564,P=0.038）;两组治疗后血压、心率及心室舒张功能指标均有明显改变,且观察组收缩压（SBP）、舒张压（DBP）及心率（HR）分别为（120.45±10.89）mm Hg、（77.45±8.44）mmHg和（70.39±5.53）次/min,均明显低于对照组（x2=4.544,P=0.035;x2=5.13,P=0.040;x2=6.05,P=0.027）;观察组治疗后左室舒张末期内径（LVEDd）和心室等容舒张时间（IVRT）分别为（47.65±4.01）mm和（101.26±4.87）ms,而E/A为（1.19±0.12）,与对照组比较差异均有统计学意义（x2=6.11,P=0.025;x2=5.82,P=0.031;x2=5.56,P=0.039）.结论 缬沙坦氢氯噻嗪分散片联合美托洛尔缓释片对高血压合并左室舒张功能减退效果显著,可有效控制患者血压,改善左室舒张功能,值得临床推广和应用.

Clinical observation of left ventricular diastolic dysfunction in patients with hypertension treated by Valsartan Hydrochlorothiazide Dispersible Tablets and Metoprolol Sustained-release Tablets

Objective To investigate clinical efficacy of left ventricular diastolic dysfunction in patients with hypertension treated by Valsartan Hydrochlorothiazide Dispersible Tablets and Metoprolol Sustained-release Tablets.Methods 110 patients of hypertension with left ventricular diastolic dysfunction were randomized into two groups,who were admitted to Huiyang District People＇s Hospital of Huizhou City from May 2011 to May 2012 were collected.The control group was only treated by Valsartan Hydrochlorothiazide conventional drug treatment,and observation group was given Metoprolol Tablets on the basis of Valsartan Hydrochlorothiazide.The clinical efficacy for both of them was compared.Results The effective rate of treatment group was 92.73％,and the effective rate of observation group was significantly higher than the control group （78.18％）,there was a statistically significant difference between the two groups （x2=5.564,P =0.038）.After treatment,blood pressure,heart rate and ventricular diastolic function parameters were significantly changed,a statistically significant difference between the two groups was indicated （P ＜ 0.05）.Systolic blood pressure （SBP）,diastolic blood pressure （DBP） and heart rate （HR） of observation group were （120.45±10.89） mm Hg,（77.45±8.44） mm Hg and （70.39±5.53） times/min,which were lower than control group （x2=4.544,P =0.035; x2=5.13,P =0.040; x2=6.05,P =0.027）; after treatment,left ventricular end diastolic diameter （LVEDd） and ventricular isovolumic relaxation time （IVRT） were （47.65±4.01） mm and （101.26±4.87） ms,while the E/A was （1.19±0.12）,compared with the control group,the differences were statistically significant （x2=6.11,P =0.025; x2=5.82,P =0.031; x2=5.56,P =0.039）.Conclusion Valsartan Hydrochlorothiazide combined with Metoprolol Tablet for hypertension and left ventricular diastolic dysfunction has significant effect,which can effectively control blood pressure and improve left ventricular diastolic function,which is worthy of promotion and application.