厄贝沙坦长期治疗对原发性高血压患者左室肥厚及心功能的影响

Effects of irbesartan on left ventricular hypertrophy and cardiac function in patients with essential hypertension

目的 :探讨血管紧张素II受体拮抗剂 (厄贝沙坦 )对原发性高血压患者左室肥厚及心功能的影响。方法 :原发性高血压患者经超声心动图检查证实左室肥厚 12 0例 ,随机分为 2组 ,每组 6 0例。厄贝沙坦组口服 15 0～ 30 0mg·d-1厄贝沙坦 ,阿替洛尔组口服 2 5～ 5 0mg·d-1阿替洛尔 ,疗程为 8个月。治疗前后各检查一次超声心动图及放射性核素心室显像 ,分析治疗前后左室重量指数及左心功能参数变化 ,并分析 2组间差异。结果 :两组治疗后收缩压与舒张压明显下降 (P <0 .0 1)。厄贝沙坦组治疗后 ,左室后壁与室间隔厚度显著下降 (P <0 .0 5 ) ,左室重量及左室重量指数下降更显著 (P <0 .0 1) ;阿替洛尔组治疗后左室后壁与室间隔厚度无明显的变化 ,而左室重量及左室重量指数下降显著 (P <0 .0 5 )。厄贝沙坦组治疗后左室高峰充盈率明显增加 (P <0 .0 5 ) ,阿替洛尔组无明显变化 ,厄贝沙坦组比阿替洛尔组左室高峰充盈率明显增高 (P <0 .0 5 )。结论 :原发性高血压患者在厄贝沙坦治疗 8个月后可使左室肥厚显著逆转及左心室舒张功能显著改善 ,对左心室舒张功能的作用优于阿替洛尔。

AIM: To explore the effects of angiotensin Ⅱ antagonist irbesartan on left ventricular hypertrophy (LVH) and cardiac function in patients with essential hypertension. METHODS: 120 patients with essential hypertension and LVH were randomized divided into two groups (n=60 in each): the irbesartan (150-300 mg·d -1 ) group and atenolol (25-50 mg·d -1 ) group, all the patients were treated for 8 months. The echocardiography and radionuclide ventriculography were examined before and after 8 months of treatment with irbesartan or atenolol. RESULTS: Data were analyzed and showed as followed: (1) After 8 months of treatment with irbesartan or atenolol, blood pressure was decreased from 159/101 to 142/89 mmHg (P< 0.01 ) or from 161/103 to 145/90 mmHg (P< 0.01 ), respectively. (2) Left ventricular mass index decreased from 165 to 128 g·m -2 (P< 0.01 ) or from 163 to 139 g·m -2 (P< 0.05 ), respectively. (3) LVPFR increased from 1.87 to 2.59 (P< 0.05 ) in irbesartan group but no change was found in the atenolol group. CONCLUSION: Long term treatment with irbesartan can result in a significant reduction of LVH and a significant amelioration of left ventricular diastolic function in patients with essential hypertension.