替米沙坦对原发性高血压患者左室肥厚及C反应蛋白的干预作用

The intervention role of telmisartan on left ventricular hypertrophy and C reactive protein in essential hypertension patients

目的探讨原发性高血压患者C反应蛋白(CRP)与左室肥厚(LVH)的关系,以及应用血管紧张素受体拮抗剂(ARB)治疗能否降低高血压患者的CRP水平及阻断或逆转LVH的发生。方法老年高血压患者50例,根据Devereux标准分为LVH组26例和无LVH组24例,予以替米沙坦治疗24w,治疗前后分别测定血压、超敏C反应蛋白(hsCRP),计算左室肥厚指数(LVMI)。结果原发性高血压伴LVH者hsCRP水平较无LVH者高(P<0.05),hsCRP与LVMI呈正相关(P<0.05);经替米沙坦治疗后两组患者的hsCRP水平均显著下降(P<0.01),左室肥厚组LVMI较用药前明显下降(P<0.01)。结论CRP水平可能是LVH的危险因子,炎症可能是形成LVH的机制之一,ARB类降压药物可通过降低CRP的水平减少LVH的发病风险。

Objective To explore the relationship between C reactive protein （CRP） and left ventricular hypertrophy （LVH） and to examine whether angiotensin receptors antagonist ARB could decrease CRP expression, block or invert the progression of LVH with essential hypertension （EH）. Methods 49 EH patients were divided into non-LVH group （n = 23 ） and LVH group （n = 26） by Devereux standard. All patients received telmisartan therapy for 24 w to detect blood pressure, hs-CRP and left ventrieular mass index （LVMI）. Results The hs-CRP level of LVH group was higher than that of non-LVH group. Hs-CRP was positively correlated with LVMI. Hs-CRP decreased obviously in non-LVH and LVH groups after treatment. LVMI decreased significantly than before treatment in LVH group （P 〈 0.01 ）. Conclusions Plasma CRP level is an independent risk factor for the development of LVH in EH. Telmisatan treatment can decrease the incident LVH by reducing CRP.