低分子肝素钠联合缬沙坦、硝酸甘油治疗高血压伴冠心病心力衰竭

目的：探讨高血压伴冠心病心力衰竭应用低分子肝素钠联合缬沙坦、硝酸甘油治疗的效果。方法：116例高血压病伴冠心病心力衰竭的患者随机分为观察组和对照组各58例。对照组给予持续低流量吸氧、抗感染、利尿、硝酸甘油扩血管等常规治疗;观察组在常规治疗基础上加用低分子肝素钠、缬沙坦联合治疗。比较两组患者治疗14d后的临床疗效、运动耐量、B类利钠肽（BNP）、和左室射血分数（LVEF）及药品不良反应。结果：观察组的总有效率为94.83%,明显优于对照组79.31%（P〈0.05）;两组患者的6 min步行距离、BNP和LVEF均较治疗前改善（P〈0.05）,且观察组改善情况明显优于对照组（P〈0.05）。两组不良反应比较差异无统计学意义（P〉0.05）。结论：低分子肝素钠联合缬沙坦、硝酸甘油治疗高血压病伴冠心病心力衰竭效果显著,可以明显提高患者运动耐量和射血分数,且不良反应发生率较低,是安全有效的治疗方法。

Low Molecular Weight Heparin Sodium Combined with Valsartan,Nitroglycerin in the Treatment of Heart Failure in Hypertensive Patients with Coronary Heart Disease

Objective ：To investigate the effect of low molecular weight heparin sodium combined with valsartan and nitroglycerin on the treatment of hypertensive patients with heart failure of coronary heart disease. Methods：116 cases of hypertensive patients with heart failure of coronary heart disease were selected form June 2008 to June 2013 in our hospital, and they were randomly divided into observation group and control group with 58 cases in either group. The control group was given continuous low flow oxygen, anti infection, diuretic, nitroglycerin vasodilator and other conventional treat- ment, and the treatment of the observation group was added with low molecular weight heparin sodium, valsartan on the basis of the conventional therapy. The improvement of heart function and adverse reactions was compared between the two groups for their clinical curative effects. Results：The total effective rate of the observation group （94.83%） was significantly better than that of the control group （79.31%）, and the difference was statistically significant （P 〈 0.05 ）. After the treatment, the heart function in the patients of the two groups were significantly improved. The observation group improved significantly better than the control group, and the difference was statistically significant （ P 〈 0.05 ） ; there was no significant difference between the two groups in their adverse reaction （ P 〉 0.05 ）. Conclusion ： There was significant effect of low molecular weight heparin sodium combined with valsartan and nitroglycerin on the treatment of the hypertensive disease with coronary heart disease and heart failure. The treatment could improve the heart function of patients, and therefore, it was a safe and effective treatment with low incidence of adverse reactions.