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托拉塞米与氢氯噻嗪联合精细化管理治疗高血压并收缩性心力衰竭患者临床疗效的对比研究 预览

Comparative Study for Clinical Effect in Treating Hypertension Patients Complicated with Systolic Heart Failure between Torasemide and Hydrochlorothiazide Combined with Fine Management
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摘要 目的比较托拉塞米与氢氯噻嗪联合精细化管理治疗高血压并收缩性心力衰竭患者的临床疗效。方法选取2017年1月—2018年1月广元市中心医院心内科门诊及病房收治的高血压并收缩性心力衰竭患者122例,采用信封法随机分为氢氯噻嗪组与托拉塞米组,每组61例。两组患者均给予药物干预联合精细化管理治疗1个月,其中氢氯噻嗪组患者利尿剂为氢氯噻嗪,托拉塞米组患者利尿剂为托拉塞米。比较两组患者临床疗效及治疗前后心功能指标〔包括左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)及血清脑钠肽(BNP)水平〕及血清超敏C反应蛋白(hs-CRP)水平,并观察两组患者治疗期间不良反应发生情况。结果托拉塞米组患者临床疗效优于氢氯噻嗪组(P<0.05)。治疗前两组患者LVEF、LVEDV及血清BNP、hs-CRP水平比较,差异无统计学意义(P>0.05);治疗后托拉塞米组患者LVEF高于氢氯噻嗪组,LVEDV小于氢氯噻嗪组,血清BNP、hs-CRP水平低于氢氯噻嗪组(P<0.05)。托拉塞米组患者治疗期间不良反应发生率低于氢氯噻嗪组(P<0.05)。结论与氢氯噻嗪联合精细化管理相比,托拉塞米联合精细化管理能更有效地提高高血压并收缩性心力衰竭患者临床疗效并改善患者心功能,且安全性较高。 Objective To compare the clinical effect in treating hypertension patients complicated with systolic heart failure between torasemide and hydrochlorothiazide combined with fine management. Methods From January 2017 to January 2018,a total of 122 hypertension patients complicated with systolic heart failure(including outpatients and inpatients)were selected in the Department of Cardiovascular Medicine,the Central Hospital of Guangyuan,and they were randomly divided into hydrochlorothiazide group and torasemide group according to the envelope method. Patients in the two groups received pharmacological intervention and fine management for 1 month,thereinto patients in hydrochlorothiazide group take hydrochlorothiazide as diuretic,while patients in torasemide group take torasemide as diuretic. Clinical effect and index of cardiac function(including LVEF,LVEDV,serum BNP level)and serum hs-CRP level before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results Clinical effect in torasemide group was statistically significantly better than that in hydrochlorothiazide group(P<0.05). No statistically significant differences of LVEF,LVEDV,serum level of BNP or hs-CRP was found between the two groups before treatment(P>0.05);after treatment,LVEF in torasemide group was statistically significantly higher than that in hydrochlorothiazide group,LVEDV in torasemide group was statistically significantly smaller than that in hydrochlorothiazide group,while serum levels of BNP and hs-CRP in torasemide group were statistically significantly lower than those in hydrochlorothiazide group(P<0.05).Incidence of adverse reactions in torasemide group was statistically significantly lower than that in hydrochlorothiazide group(P<0.05). Conclusion Compared with hydrochlorothiazide combined with fine management,torasemide combined with fine management can more effectively improve the clinical effect and cardiac function in hypertension patients complicated with systo
作者 杨莉君 张邱兵 冯德刚 邓丽 余田 YANG Li-jun;ZHANG Qiu-bing;FENG De-gang;DENG Li;YU Tian(Department of Cardiovascular Medicine,the Central Hospital of Guangyuan,Guangyuan 628000,China)
出处 《实用心脑肺血管病杂志》 2018年第11期86-89,共4页 Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金 四川省医学科研青年创新课题计划项目(Q15042).
关键词 心力衰竭 收缩性 高血压 托拉塞米 氢氯噻嗪 精细化管理 疗效比较研究 Heart failure,systolic Hypertension Tolasemide Hydrochlorothiazide Fine management Comparative effectiveness research
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