厄贝沙坦与非洛地平联用对高血压病左室肥厚的逆转作用

Effect of Irbesartan Combined with Felodipine on Reversing Left Ventricular Hypertrophy in Patients with Essential Hypertension

目的探讨厄贝沙坦、非洛地平联合用药对原发性高血压(EH)病人左室肥厚(LVH)的逆转作用。方法EH伴LVH病人180例随机分为对照组(非洛地平每天10mg,90例)和治疗组(厄贝沙坦每天75mg加非洛地平每天5mg,90例),治疗两周时若血压≥160/90mmHg,则厄贝沙坦和非洛地平分别增加1倍,总疗程共6个月。治疗前后观察心率变化、24h动态血压监测和彩色超声多普勒检测左室相关指标,计算左室重量指数(LVMI)。结果两组治疗后均能显著降低LVMI(P<0.01),且治疗组较对照组更为显著(P<0.01);两组治疗前心率、24h平均收缩压、平均舒张压比较无统计学意义(P>0.05),治疗后24h平均收缩压、平均舒张压较治疗前显著降低(P<0.01),但治疗后两组间无统计学意义(P>0.05)。结论厄贝沙坦与非洛地平联用逆转EH病人LVH效果较单用非洛地平疗效更为显著。

Objective To study the effects of irbesartan and irbesartan with felodipine on reversing Left ventricular hypertrophy (LVH) in patient with essential hypertension (EH).Methods One hundred and eighty patients (pts) with EH were divided randomly into two groups:the controlled group (felodipin 10 mg/d,n=90) and the test group(irbesartan 75 mg/d with felodipine 5 mg/d,n=90).If the blood pressure ≥160/95 mmHg was remained after two weeks therapy,the dosage will be doubled and the therapy will be lasted for 6 months.The left ventricle mass index (LVMI) was measured by Doppler ultrasound pre and post-therapy.The blood pressure was recorded by ABPM and changes of heart rate were observed at the same time.Results Following therapy for 6 months,LVMI decreased significantly in the treatment group(P<0.01).LVMI in the test group decreased more than that in the controlled group (P<0.01).There were no differences for the heart rate/24 h,SBP and DBP/24 h significantly pre-therapy in two groups(P>0.05).Following therapy for 6 months,SBP/24 h and DBP/24 h decreased significantly (P<0.01),but there were no difference between the two groups(P>0.05).Conclusion The results suggest that irbesartan combined with felodipine be able to increase the effect on reversing LVH in patients with EH.