摘要
高血压合并心力衰竭是临床常见的心血管疾病，其病理生理机制复杂，涉及神经内分泌系统激活和心脏重构等多方面因素，传统治疗手段在改善患者预后方面存在局限性，因此探索更为有效的治疗策略具有重要意义本研究旨在评估依那普利在高血压合并心力衰竭患者中的治疗效果及安全性，为临床实践提供依据研究采用前瞻性随机对照设计，纳入120例符合诊断标准的患者，将其随机分为依那普利治疗组和常规治疗对照组，疗程持续6个月通过比较两组患者的血压水平、左心室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)浓度及不良事件发生率等指标，全面评价依那普利的疗效结果表明，依那普利治疗组患者的血压显著降低，LVEF明显提高，NT-proBNP水平下降幅度更大，且未见严重不良反应发生这提示依那普利不仅能有效控制血压，还能改善心脏功能，延缓心脏重构进程，其创新点在于首次系统性验证了依那普利在该类患者中的综合获益，为优化治疗方案提供了重要参考关键词：高血压；心力衰竭；依那普利；左心室射血分数；N末端脑钠肽前体
Therapeutic Efficacy of Enalapril in Patients with Hypertension and Heart Failure
Abstract
Hypertension combined with heart failure is a common cardiovascular disease in clinical practice, characterized by complex pathophysiological mechanisms involving the activation of the neuroendocrine system and cardiac remodeling, among other factors. Conventional treatment approaches have limitations in improving patient prognosis, thus highlighting the importance of exploring more effective therapeutic strategies. This study aimed to evaluate the efficacy and safety of enalapril in patients with hypertension combined with heart failure, providing evidence for clinical application. A prospective randomized controlled design was adopted, enrolling 120 patients who met the diagnostic criteria, which were randomly divided into an enalapril treatment group and a conventional treatment control group, with a treatment duration of six months. The therapeutic effects of enalapril were comprehensively assessed by comparing blood pressure levels, left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, and the incidence of adverse events between the two groups. The results demonstrated that patients in the enalapril treatment group experienced significant reductions in blood pressure, marked improvements in LVEF, and greater decreases in NT-proBNP levels, with no severe adverse reactions observed. These findings suggest that enalapril not only effectively controls blood pressure but also improves cardiac function and slows the progression of cardiac remodeling. The novelty of this study lies in its systematic validation of the comprehensive benefits of enalapril in this patient population, offering important reference for optimizing treatment protocols.
Keywords: Hypertension; Heart Failure; Enalapril; Left Ventricular Ejection Fraction; N Terminal Pro Brain Natriuretic Peptide
目录
摘要 I
Abstract II
引言 1
1 依那普利的药理机制与临床意义 1
1.1 依那普利的作用机制分析 1
1.2 高血压合并心衰的病理特点 2
1.3 药物干预在心衰治疗中的地位 2
2 依那普利对高血压合并心力衰竭的疗效评估 3
2.1 血压控制效果的研究 3
2.2 心功能改善的具体表现 3
2.3 不良反应及耐受性分析 4
3 依那普利与其他药物的对比研究 4
3.1 与其他药物的对比 4
3.2 选择依据 5
3.3 综合疗效评价 5
4 依那普利在长期治疗中的应用价值 5
4.1 长期用药的安全性探讨 5
4.2 患者生活质量的改善情况 6
4.3 依那普利的临床推广前景 6
结论 7
参考文献 8
致谢 9
