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目的:探索苯磺酸氨氯地平联合比索洛尔治疗老年单纯收缩期高血压(ISH)并射血分数保留性心力衰竭(HFp EF)的疗效及安全性。方法:选择惠州市中医医院2014年6月至2016年6月门诊及住院部诊治的120例老年ISH并HFp EF患者按随机数字表分为治疗组和对照1组、对照2组各40例。3组均在基础治疗上,对照1组给予苯磺酸氨氯地平口服、对照2组给予比索洛尔口服,治疗组同时给予苯磺酸氨氯地平和比索洛尔口服。对3组患者血压、左室舒张末期内经(LVEDD)、血清N末端脑钠肽前体(NT-pro BNP)、6 min步行距离进行统计。结果:(1)治疗组总有效率为95.0%,显著高于对照1组(75.0%)和对照2组(72.5%)(P<0.01)。(2)与治疗前比较,3组血压和血清NT-pro BNP有不同程度的降低,差异具有统计学意义(P<0.05,P<0.01),其中治疗组收缩压及血清NT-pro BNP显著降低,与两组对照组相比,差异具有统计学意义(P<0.05)。(3)经治疗后,3组LVEDD明显改善,对比治疗前差异具有统计学意义(P<0.05),其中治疗组改善情况与两组对照组对比差异具有统计学意义(P<0.05)。(4)3组6 min步行试验指标对比治疗前差异具有统计学意义(P<0.01),其中治疗组改善情况与两组对照组相比差异具有统计学意义(P<0.05)。结论:苯磺酸氨氯地平联合比索洛尔治疗老年ISH并HFp EF患者,不仅可获得协同的降压效果,还可显著改善患者的心功能,且未见明显不良反应,安全有效。
Objective: To investigate the efficacy and safety of amlodipine besylate combined with bisoprolol in the treatment of senile isolated systolic hypertension (ISH) and ejection fractional retention heart failure (HFp EF). Methods: A total of 120 elderly patients with ISH and HFp EF diagnosed and treated in Huazhong Hospital of Traditional Chinese Medicine from June 2014 to June 2016 were divided into treatment group and control group by random number table, and control group (40 cases). All the three groups were treated with amlodipine besylate, the control group 1 was given oral bisoprolol, while the other two groups were treated with amlodipine besylate and bisoprolol orally. The blood pressure, LVEDD, NT-proBNP, 6-minute walking distance were calculated in three groups. Results: (1) The total effective rate was 95.0% in the treatment group, which was significantly higher than that in the control group 1 (75.0%) and the control group 2 (72.5%) (P <0.01). (2) Compared with before treatment, blood pressure and serum NT-pro BNP in 3 groups decreased to some extent, the difference was statistically significant (P <0.05, P <0.01), including systolic blood pressure and serum NT-pro BNP in treatment group were significantly Compared with the two control groups, the difference was statistically significant (P <0.05). (3) After treatment, the LVEDD of the three groups were significantly improved (P <0.05), and the improvement of the treatment group was statistically significant compared with the control group (P <0.05). (4) The 6-minute walking test of 3 groups showed significant difference compared with that before treatment (P <0.01), and there was significant difference between the two groups in the improvement of the treatment group and the control group (P <0.05). Conclusion: Combination of amlodipine besylate and bisoprolol in elderly patients with ISH and HFp EF can not only achieve synergistic antihypertensive effect, but also improve cardiac function in patients with no significant adverse reactions and is safe and effective.