氨氯地平和依那普利联合治疗高血压病左心室舒张功能不全的疗效

Combined administration of levamlodipine and enalapril in treatment of hypertensive patients with left ventricular diastolic dysfunction

目的:研究高血压病患者左室舒张功能不全治疗的最佳方案。方法:将60例门诊高血压病患者随机分为3组:氨氯地平组给予苯磺酸左旋氨氯地平5 mg每晚1次;依那普利组给予马来酸依那普利10 mg每日2次;联合用药组给予苯磺酸左旋氨氯地平2.5 mg每晚1次+马来酸依那普利5 mg每日2次。对比治疗前和6个月后随访时的左室射血分数(LVEF)、心电机械图S2至E峰时间(IVRT)、二尖瓣血流峰值速度E/A,并对比各组中不良反应的发生率。结果:3组内治疗前后LVEF无显著性差异;IVRT、E/A改善具有显著性。3组间治疗后结果比较LVEF、IVRT均无统计学差异,联合用药组E/A较单独用药组具有统计学差异(均P<0.05)。结论:对伴有左心室舒张功能不全的高血压病患者,氨氯地平和依那普利对舒张功能的指标均有改善;而氨氯地平和依那普利小剂量联合使用,对舒张功能的指标E/A有更显著地改善,且副作用发生率较低。

AIM： To explore a better therapy program for hypertensive patients with left ventricular diastolic dysfunction. METHODS： Sixty hypertensive out-patients were randomly divided into three groups： Group 1 treated with levamlodipine besilate （5 rag ） nightly, Group 2 treated with enalapril maleate （10 rag） twice daily, and Group 3 treated with levamlodipine besilate （2. 5 mg） nightly plus enalapril maleate （5 rag） twice daily. LVEF, IVRT, E/A, and side effects were recorded before treatment and 6 months after treatment. RESULTS： LVEF of the three groups before and after treatment showed no significant differences. IVRT and E/A improved significantly （ P 〈 0. 05 ）. After treatment, LYEF and IVRT showed no significant difference among the three groups. Compared with that in Group 1 and Group 2, Group 3 E/A was significantly different （ P 〈 0.05 ）. CONCLUSION ： In the treatment of hypertensive patients with diastolic dysfunction, levamlodipine besilate and enalapril maleate improve the indicator of diastolic function. The combination of low-dose levamlodipine besilate and enalapril maleate significantly improves the E/A with few side effects.