缬沙坦治疗高血压病合并舒张性心功能不全116例

Effects of valsartan on hypertension with diastolic heart dysfunction in 116 patients

目的:探讨缬沙坦对血管紧张肽转换酶抑制药不能耐受的高血压合并舒张性心力衰竭(心衰)病人心功能的影响。方法:116例高血压合并左室扩大舒张性心衰病人随机分为治疗组61例,对照组55例,均给予硝酸异山梨醇酯10mg,po,tid,阿司匹林100mg,po,qd;治疗组加服缬沙坦80～160mg, po,qd,对照组加服尼群地平10～20mg,po,tid,疗程均为6mo。采用超声心动图进行对比观察。结果:治疗组反映左室形态的指标(LVID和LVMW)及反映左室舒张功能指标(E峰,A峰,E/A比值, VTIE,VTIA,E-VTI/A-VTI)有明显改善(P<0.05),与对照组比较差异显著(P<0.05)。临床疗效评定,治疗组及对照组总有效率分别为87％和54％,死亡率分别为2％和9％,2组比较有非常显著差异(p<0.01)。结论:缬沙坦不仅可改善左室舒张功能,逆转扩大的左心室,并明显降低死亡率。

AIM： To investigate the effects of valsartan on cardiac function of hypertension with left ventricular dilatation and diastolic heart failure in patients with the history of intolerance to angiotensin-converting enzyme inhibitors. METHODS： One hundred sixteen patients with diastolic heart failure were randomized into the therapy group （61 patients） and the control group （55 patients） . The patients in the therapy group were given valsartan （80 - 160 mg, po, qd）, isosorbide dinitrate （10 mg, po, tid） and aspilin （100 mg, po, qd） and patients in the control group were given nitrendipine （10 - 20 mg, po, tid）, isosorbide dinitrate （10 rag, po, tid）, and aspilin （100 rag, po, qd） for 6 mo. The heart function were measured by echocardiography. RESULTS： Compared to the control group, the index of left ventricular remodeling （LVID and LVMW） and left ventricular diastolic function （VmaxE, VmaxA, E/A, VTIE, E-VTI/A-VTI） in the therapy group improved significantly （P 〈 0.05） . The total effective rate was 87 % and 54 % respectively in the treatment group and control group with the mortality was 2 % and 9 % respectively. There was significant difference between the two groups （P 〈 0.01） . CONCLUSION： Valsartan could reverse the dilated left ventricle, improve the left ventricular diastolic function, and reduce mortality remarkably.