厄贝沙坦、硝苯地平控释片及美托洛尔对高血压左心室肥厚的作用

The contrast study of irbesartan,nifedipin GITS and metoprolol converting left ventricular hypertrophy in essential hypertensive patients

目的比较厄贝沙坦,硝苯地平控释片及美托洛尔对高血压合并左心室肥厚(LVH)的逆转作用。方法92例高血压LVH患者随机分为厄贝沙坦组(31例),硝苯地平控释片组(31例)和美托洛尔组(30例),分别使用厄贝沙坦150～300mg,1次/d,硝苯地平控释片30～60mg,1次/d,美托洛尔25～50mg,2次/d,疗程6个月,治疗前后进行偶测血压(CBP)、动态血压(ABPM)及超声心动图检查。结果三组患者的血压均显著下降,舒张期左室后壁厚度(LVPWT)、舒张期室间隔厚度(IVST)、左室舒张末期内径(LVDd)、左室重量指数(LVMI)均有显著改善(P<0.05～0.01),LVH得到逆转,而厄贝沙坦组的逆转程度大于硝苯地平控释组及美托洛尔组(P<0.05)。结论三种药物均能有效降压,对LVH有不同程度的逆转作用,但厄贝沙坦的逆转作用相对较强。

Objective To investigate the effects of conversal left ventricular hypertrophy(LVH) of irbesartan,nifedipin GITS and metoprolol in essential hypertension(EH).Methods 92 EH patients with left ventricular hypertrophy were divided into irbesartan group,nifedipin GITS group and metoprolol group at random,the daily dose of irbesartan was 150～300mg,nifedipin GITS was 30～60mg and metoprolol was 25～50mg,the treatment lasted for 6 months.Before administration and at 6th month after administration,casual blood pressure(CBP) and 24-hour amhulatory blood pressure monitoring(ABPM) were observed,and echocardiography was also detected.Results CBP and ABPM was significantly reduced by three drugs,after 6 months treatment of three drugs,interventricular septal thickness(IVST),left ventricular internal diameter at end-diastole(LVDd) and left ventricular mass index(LVMI) were improved significantly(P<0.05～0.01),LVH was decreased,the decrease in irbesartan group was more remarkable than that in nifedipin GITS group and metoprolol group(P<0.05).Conclusion Three drugs could effectively control the hypertension and differently convert LVH;but when concerning on converting LVH,irbesartan was the best one of the three.