内科

目的探讨比索洛尔联合贝尼地平治疗不同基础心率老年高血压患者的降压效果及对患者心率的影响。方法选取2016年12月至2017年12月我院收治的老年高血压患者229例为研究对象，根据基础心率分为A组、B组、C组。 A组患者77例，心率70～79次/min；B组患者96例，心率80～89次/min；C组患者56例，心率≥90次/min。三组患者均服用比索洛尔和贝尼地平治疗，疗程6周。比较三组患者治疗前后的血压水平、基础心率及其降幅的周平均值以及不良反应的发生情况。结果治疗后，三组患者的舒张压和收缩压水平均显著降低，但三组患者的水平比较差异无统计学意义（P＞0.05）；三组患者的基础心率均显著降低, 其降低幅度表现为C组＞B组＞A组，差异有统计学意义（P＜0.05），但三组患者治疗后的基础心率比较差异无统计学意义（P＞0.05）。治疗期间，C组患者头晕头痛、干咳、恶心呕吐、疲劳的发生率均高于A组，B组患者恶心呕吐的发生率显著高于A组，差异有统计学意义（P＜0.05）。结论比索洛尔联合贝尼地平可显著降低患者的血压和基础心率；患者的年龄越高其基础心率越快，治疗后其基础心率降幅越大，副作用越多，临床治疗须根据患者的基础心率进行给药，同时根据患者的不良反应及时进行调整比索洛尔剂量。

ObjectiveTo explore anti-hypertensive effect of bisoprolol combined with benidipine and its effect on heart rate for elderly hypertensive patients in different basic heart rates. MethodsA total of 229 elderly patients with hypertension admitted to our hospital from December 2016 to December 2017 were selected as the research subjects, and they were divided into group A, group B, and group C based on the basic heart rate. Seventy-seven patients in group A had a heart rate of 70-79 beats/min; 96 patients in group B had a heart rate of 80-89 beats/min; 56 patients in group C had a heart rate of ≥90 beats/min. All the three groups were administered bisoprolol and benidipine for six-week treatment courses. The blood pressure level, basic heart rate, weekly average of the decrease of basic heart rate, and the occurrence of adverse reactions were compared between the three groups before and after treatment. ResultsAfter treatment, diastolic blood pressure and systolic blood pressure levels of the three groups significantly decreased; however, there were no statistically significant differences in the levels of the three groups (P＞0.05). The basic heart rate of the three groups significantly decreased, and the levels of basic heart rate of the three groups in a descending order were group C, B and A, with statistically significant difference (P＜0.05). There was no statistically significant difference in post-treatment basic heart rate between the three groups (P＞0.05). During treatment, compared to group A, patients in group C obtained higher incidence of dizziness, headache, dry cough, nausea and vomiting, and fatigue, whereas group B yielded higher incidence of nausea and vomiting, with statistically significant differences (P＜0.05). ConclusionBisoprolol combined with benidipine can significantly decrease the blood pressure and basic heart rate of patients. The older age the patients are, the faster basic heart rate they have, then the more basic heart rate decreases after treatment, but the more side effect the patients have. Medicine must be administered according to the basic heart rate of patients in clinical treatment, and the bisoprolol dose should be adjusted in time according to adverse reactions.