缬沙坦与络活喜联合治疗高血压糖尿病心功能不全的临床研究

The clinical study on the effect of valsartan and Amlodipine in the treatment of hypertension with diabetes and cardiac dysfunction

目的探讨缬沙坦与络活喜联合治疗高血压糖尿病病心功能不全的临床疗效。方法59例高血压糖尿病心功能不全病人随机分为两组即联合治疗组(30例)及依那普利治疗组(29例),联合治疗组给予缬沙坦80mg/qd,络活喜5mg/qd;依那普利治疗组给予依那普利10mg/qd,利血平或罗布麻等其他治疗,疗程为12个月。治疗前及治疗6、12个月后测量以下指标:左室舒张末期内径(LVDd)、室间隔与左室后壁舒张末期厚度(IVSTd和LVPWTd)、左室重量指数(LVMi)、左室射血分数(EF)、等容舒张时间(IRT)、二尖瓣瓣尖处测量舒张早期峰值速度(E峰)及舒张晚期峰值速度(A峰)、E/A比值。结果治疗6个月后两组病人均有改善心功能作用,但治疗12个月后联合治疗组疗效明显优于依那普利组(P<0.05),各项指标LVDd、IVSTd、LVPWTd、IRT及LVMI均明显降低,EF值、E/A明显升高(P<0.05)。治疗前后对血液电解质、血糖,血脂影响无显著差异(P>0.05)。结论缬沙坦联合络活喜治疗高血压病糖尿病、改善心功能不全疗效显著。

Objective ：To investigate the effect of valartan and Amlodipine in treating hypertension with diabetes and cardiac dysfunction. Methods ： 59 patients with hypertension and diabetes and cardiac dysfunction were randomly allocated to combination treatment group and Enalapril group, the combination treatment group （30 cases,conventional therapy with combination of valsartan 80mg/qd and Amlodipine 5mg/bid）, Enalapril group （29 cases, conventional therapy with Enalapril 10mg/qd）, The course of treatment was 12 months. The blood pressure（BP） ,heart rate（HR） .left ventricular ejection fraction（LVEF） and mitral valve peak flow velocity E/A ratio were measured and compared in each group before and after 6 months and 12 months＇ treatment. Result： After 6 months and 12 months＇ treatment, the patients in combination treatment group had significant clinical effect （New York Heart Association （NYHA） classification improved 1--2 degree） compared with that of Enalapril group（P〈 0. 05）, the BP. HR were significantly improved and LVEF. E/A ratio significantly increased in combination treatment group compared with the Enalapril group（P〈0.05）with no severe side effect and better endurance. Conclusions： Conventional therapy with combination of valsartan and Amlodinine has obvious clinic effect compared with that in Enalanril in treating hypertension with diabetes and cardiac dysfunction.