不同剂量氢氯噻嗪联合缬沙坦治疗高血压病合并舒张性心功能不全的临床观察

目的探讨高血压病患者合并舒张性心功能不全发生时采用不同剂量的氢氯噻嗪与缬沙坦联合治疗的临床效果。方法本次研究选择的对象共120例,均为我院2010年2月至2012年2月收治的高血压病与舒张性心功能不全合并发生的患者,按观察组A、观察组B、对照组各40例划分,在常规治疗的基础上,观察组A、B组分别加用不同剂量氯氨噻嗪与缬沙坦联合口服,观察组加用硝苯地平缓释片口服,回顾三组临床资料。结果观察组A总有效率为87.5%,观察组B为90%,对照组为65%,观察组各组显著高于对照组(P>0.05),观察组各组间比较差异不明显(P<0.05)。观察组各组无死亡事件发生,对照组因心源性猝死死亡5例,占12.5%,观察组各组间病死率显著低于对照组(P<0.05)。两组均无严重并发症发生。观察组各组E峰均上升,A峰均下降,E/A比值明显改善,对照组改善均不明显(P<0.05),LVMW指标、LVID指标、VTLA指标、VTIE指标观察组各组情况均优于对照组(P<0.05)。结论高血压与舒张性心功能不全合并发生的患者采用氢氯噻嗪(小剂量)联合缬沙担治疗,可显著改善预后,提高患者生存质量。

Clinical Observation of Different Doses of Hydrochlorothiazide Combination of Valsartan in Treatment of Essential Hypertension with Diastolic Heart Failure

Objective To investigate the hypertensive patients with diastolic heart failure occurs with different doses of hydrochlorothiazide and clinical therapeutic effect of valsartan combined with.Method This study selected a total of 120 cases in our hospital in 2010,are from February to 2012 February were treated hypertension and diastolic heart failure combined incidence of patients in observation group,A,B in the observation group,the control group with 40 cases in each group division,on the basis of routine treatment,the observation group A,group B respectively with different doses of chlorine and ammonia thiazide and valsartan combined with oral,added to the observation group nifedipine oral,retrospective clinical data in the three groups.Results The treatment group total effective rate of A was 87.5%,B was 90% in the observation group,65% in control group,the observation group were significantly higher than those in control group（P0.05）,the observation group was not significantly different between groups and comparison（P0.05）.Observation group no deaths occurred,the control group suffered sudden cardiac deaths in 5 cases,accounting for 12.5%,the observation group groups mortality was significantly lower than the control group（P0.05）.The two groups were no serious complication.Observation group E peaks rise,peak A decreased,E/A ratio were significantly improved,the control group were improved significantly（P0.05）,not LVMW index,LVID index,VTLA index,VTIE index of observation group were superior to that in the control group（P0.05）.Conclusion Hypertension and diastolic heart failure combined with hydrochlorothiazide（low dose） combined with valerian sand TAM treatment,can significantly improve the prognosis,improve patients＇ quality of life.