伊贝沙坦对高血压患者QT离散度的影响

The effect of irbesartan on QT dispersion in hypertensives

目的 评价伊贝沙坦对轻中度高血压患者QT离散度 (QTd)的影响。方法 34例未治疗的轻中度高血压患者接受 30周的伊贝沙坦 15 0mg治疗 ,必要时加用双氢氯噻嗪 12 5mg。治疗前后分别进行血压测量 ,超声心动图检查计算左室重量指数 (LVMI) ,12导联心电图测量QT间期与QTd。结果 伊贝沙坦治疗后 ,患者血压从(15 7± 13/10 2± 7)mmHg (1mmHg =0 133kPa)降至 (135± 10 /88± 5 )mmHg ,QTd由 (5 2 5± 2 1 4 )ms降至 (41 3± 19 6 )ms (P <0 0 5 ) ,但LVMI下降未达显著性差异 (P >0 0 5 )。QTd减少与LVMI降低呈显著正相关 (r =0 382 ,P <0 0 5 )。结论 伊贝沙坦治疗能降低轻中度高血压患者的QTd ,以上改变可能与LVMI的降低有关。

Objective To study the effect of irbesartan on QT dispersion(QTd)in mild to moderate hypertensive patients.Methods Thirty-four previously untreated patients with mild to moderate hypertension were assigned to a 30-week treatment study with irbesartan 150 mg titrated to irbesartan 150 mg-hydrochlorothiazide 12.5 mg.Blood pressure and echocardiographic left ventricular mass index(LVMI)were measured before and after 30 weeks of treatment.QT interval and QTd were obtained from standard 12-lead electrocardiograms at baseline and after 30 weeks of therapy.Results Irbesartan significantly reduced blood pressure from(157±13/102±7)mmHg to(135±10/88±5)mmHg and QTd from(52.5±21.4)ms to(41.3±19.6)ms(P<0.05).But the reduction in LVMI did not quite reach statistical significance(P>0.05).The reduction in QTd correlated positively with the corresponding reduction in LVMI(r=0.382,P<0.05),but not the change in systolic and diastolic blood pressure.Conclusion Irbesartan significantly reduced QTd after 30 weeks of treatment in patients with mild to moderate hypertension,and this improvement seemed to be mediated by a reduction in LVMI.