培他乐克、波依定和洛汀新对高血压病左室重构的影响

Metoprolol、Felodipine, Lotensin on Left Ventricular Remodeling in Hypertensive Patients

目的 探讨用 β -阻滞剂、钙拮抗剂 (CaA)和血管紧张素转换酶抑制剂 (ACEI)长期治疗对高血压病左室重构的影响。方法 412例高血压病Ⅰ级或Ⅱ级患者服用降压药 5 .3± 0 .7年 ,随机分为 β -阻滞剂组、CaA组、ACEI组、对照组 ,观察疗效及对左室重构的影响。结果 长期服用 β-阻滞剂、CaA或ACEI不仅能使血压稳定在较低水平 ,而且可逆转左室肥厚 ,改善心功能 ,其中尤以 β -阻滞剂为明显 ,它可降低病死率及心源性猝死发生率。而对照组上述指标均较CaA、ACEI和 β-阻滞剂组有加重趋势 ,其加重程度和观察时间呈正相关 (P <0 .0 1)。 结论 长期 β -阻滞剂、CaA或ACEI治疗可逆转左室重构 。

Objective To evaluate long-term effects of β-blocker,calcium antagonist,ACEI on left ventricular remodeling in hypertensive patients.Method 412 patients with hypertension were treated by us and follow up 5.3±0.7 years,they were randomly divided into 4 groups.Result β-blocker,calcium antagonist and ACEI not only have an affirmative effect on high blood pressure,and also have an effect of regressing left ventricular remodeling and improving cardiac function.Most significantly of them is β-blocker,it could decrease mortality and rate of cardiac sudden death.Conclusion β-blocker ,CaA or ACEI might regress left ventricular remodeling and improve prognosis of hypertensive patients.