目的 分析依那普利在中老年慢性肺源性心病(简称慢性肺心病)患者肺动脉高压中的应用效果.方法 随机选择2021年2月—2022年2月右江民族医学院附属医院呼吸内科收治的70例中老年慢性肺心病患者为研究对象,采用抽签法将其分为对照组和观察组(各35例),对照组采用福辛普利钠片治疗,观察组采用依那普利联合福辛普利钠片治疗,治疗3个月后,对比两组患者的临床疗效、心功能指标、内皮素-1(Endo-thelin-1,ET-1)、氨基末端脑利钠肽前体(Nterminal Pro Brain Natriuretic Peptide,NT-proBNP)水平、血氧指标及不良反应等.结果 观察组疗效(94.29%)高于对照组(74.29%),差异有统计学意义(χ2=5.285,P<0.05);两组患者治疗后右心室射血分数指标相较于治疗前均有所提高,且观察组高于对照组,两组患者右心室舒张末期内径、肺动脉收缩压水平指标均有所降低,且观察组低于对照组,差异有统计学意义(P均<0.05);相较于对照组,观察组ET-1、NT-proBNP水平更低,差异有统计学意义(P均<0.05).观察组治疗后动脉血氧分压水平高于对照组,动脉血二氧化碳分压水平低于对照组,差异有统计学意义(P均<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).结论 依那普利在中老年慢性肺心病患者肺动脉高压中的应用效果明确,可以改善患者的心功能指标,防止右心室重构,降低脉动脉高压,且不会增加患者不良反应.
Effect of Enalapril on Pulmonary Hypertension in Middle-aged and El-derly Patients with Chronic Pulmonary Heart Disease
Objective To analyze the effect of enalapril on pulmonary hypertension in middle-aged and elderly pa-tients with chronic pulmonary heart disease(chronic pulmonary heart disease).Methods Seventy middle-aged and el-derly patients with chronic pulmonary heart disease admitted to the respiratory department of Youjiang Medical Col-lege for Nationalities Affiliated Hospital from February 2021 to February 2022 were randomly selected as the study ob-jects and divided into control group and observation group by drawing lots(n=35).The control group was treated with fosinopril sodium tablets,and the observation group was treated with enalapril combined with fosinopril sodium tab-lets.After three months of treatment,clinical efficacy,cardiac function indicators,endothelin-1(ET-1),the level of amino-terminal brain natriuretic peptide precursor(NT-proBNP),blood oxygen indicators and adverse reactions were compared between the two groups.Results The curative effect of observation group(94.29%)was higher than that of control group(74.29%),and the difference was statistically significant(χ2=5.285,P<0.05).RVEF indexes in both groups were improved after treatment compared with before treatment,and the observation group was higher than the control group,RVEDD and PASP indexes were decreased in both groups,and observation group was lower than con-trol group,and the differences were statistically significant(all P<0.05).Compared with the control group,the levels of ET-1 and NT-proBNP in the observation group were lower,and the differences were statistically significant(both P<0.05).After treatment,the level of arterial partial pressure of oxygen in the observation group was higher than that in the control group,and the level of arterial partial pressure of carbon dioxide was lower than that in the control group,and the differences were statistically significant(all P<0.05).There was no statistical significance difference in ad-verse reactions between the two groups(P>0.05).Conclusion The application effect of enalapril in pulmonary hyper-tension in middle-aged and elderly patients with chronic pulmonary heart disease is clear,which can improve the car-diac function indicators of patients,prevent right ventricular remodeling,reduce arterial hypertension,and do not in-crease the adverse reactions of patients.
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