降压治疗对高血压合并类风湿关节炎患者血流动力学的影响

N. A. Samorodskaya, L. N. Eliseeva
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摘要

研究目标。评价不同类别药物降压6个月对高血压合并类风湿关节炎患者循环系统血流动力学参数的影响材料和方法。将符合年龄(58.6±6.4岁)、高血压病程(11.2±1.6年)、发病(45-64岁)、类风湿关节炎病程(7.2±2.1年)标准的患者分为两组:I组(男性136例,女性141例)- II期高血压277例;II组(28名男性,114名女性)- 142例II期高血压和类风湿关节炎患者(临床-实验室缓解);III组(20名男性,92名女性)- 112名II期高血压和类风湿关节炎患者(临床-实验室加重)。抗高血压的单药治疗是由综合门诊医生开的:奈比洛尔、赖诺普利、氯沙坦、氨氯地平、吲达帕胺,以及赖诺普利和吲达帕胺的联合治疗。观察6个月。结果。降压治疗(6个月)对I组和II组患者循环系统血流动力学参数的影响以形态计量学和速度参数的正动态表现,而III组患者的指标不太显著且距离较远。结论。类风湿关节炎的存在引入了处方降压治疗的血流动力学效应的额外变化,并由疾病活动程度和基本抗炎治疗的充分性决定。
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Hemodynamic effects of antihypertensive therapy in patients with hypertension and rheumatoid arthritis comorbidity
Research  objective.  Evaluation  of the influence  of 6-month  antihypertensive  therapy  with  drugs  of different  classes on hemodynamic parameters of the circulatory system in patients with comorbid hypertension and rheumatoid arthritis. Materials and methods. Patients who met age criteria (58.6 ± 6.4 years), duration of hypertension (11.2 ± 1.6 years), onset (aged 45–64 years), and duration (7.2 ± 2.1 years) of rheumatoid arthritis were divided into groups: Group I (136 men, 141 women) — 277 patients  with stage II hypertension;  Group II (28 men, 114 women)  — 142 patients  with stage II  hypertension  and rheumatoid arthritis (in clinical-laboratory remission); Group III (20 men, 92 women) — 112 patients with stage II hypertension and rheumatoid arthritis (in clinical-laboratory  exacerbation). Antihypertensive  monotherapy was prescribed by polyclinic doctors: nebivolol, lisinopril, losartan, amlodipine, indapamide, and a combination of lisinopril and indapamide. Observation was carried out for 6 months. Results. The influence of antihypertensive therapy (6 months) on hemodynamic parameters of the circulatory system in patients of groups I and II was presented by positive dynamics of morphometric and speed parameters, while in group III patients the indicators were less significant and more distant. Conclusion.  The presence of rheumatoid arthritis introduces additional changes in the dynamics of hemodynamic effects of prescribed antihypertensive therapy and is determined by the degree of disease activity and adequacy of basic anti-inflammatory therapy.
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