复方缬沙坦对原发性高血压左室肥厚及舒张功能的影响

Effect of Valsartan/HCTZ on Left Ventricular Hypertrophy and Diastolic Function in Patients with Primary Hypertension

目的观察复方缬沙坦对轻-中度原发性高血压左室肥厚及舒张功能的影响。方法收集轻-中度原发性高血压伴左室肥厚患者102例,经洗脱2周后随机分为两组,观察组(n=62)患者口服复方缬沙坦(缬沙坦80mg+氢氯噻嗪12.5 mg),对照组(n=40)患者口服缬沙坦(80 mg/d),均治疗30周。比较两组患者治疗前后的血压、心率、左室重量指数(LVMI)、左室等容舒张时间(IVRT)、舒张早期峰值速度(E)/舒张晚期峰值速度(A)比值及E峰减速时间(DT)。结果两组患者治疗30周后血压、LVMI、IVRT、DT及E/A比值均较治疗前显著改善(P<0.05)。观察组患者治疗后收缩压、舒张压降低幅度〔(37±10)mmHg和(22±6)mmHg〕均显著大于对照组〔(26±10)mm Hg和(11±5)mm Hg〕,差异有统计学意义(P<0.05);且LVMI、IVRT、DT减少幅度〔(18±7)g/m2、(22±9)ms和(90±18)ms〕,均显著大于对照组〔(14±6)g/m2、(18±7)ms和(81±20)ms〕,E/A比值升幅(0.68±0.3)亦显著大于对照组(0.48±0.2),差异均有统计学意义(P<0.05)。结论复方缬沙坦及缬沙坦在有效降低轻-中度原发性高血压患者血压水平的同时,能明显改善左室肥厚及舒张功能,前者效果更显著。

Objective To observe the effect of valsartan/hydrochlorothiazide（HCTZ） on left ventricular hypertrophy and diastolic function in patients with mild or moderate essential hypertension（EH）.Methods One hundred two patients with mild or moderate EH and left ventricular hypertrophy were divided,after elution,into groups observation（n=62,receiving valsartan 80 mg＋HCTZ 12.5 mg,30 weeks） and control（n=40,receiving valsartan 80 mg,30 weeks）.Blood pressure（BP）,heart rate（HR）,left ventricular mass index（LVMI）,left ventricular isovolumic relaxation time（IVRT）,early diastolic peak velocity（E）/late diastolic peak velocity（A） ratio,E peak deceleration（DT） were determined.Results BP,LVMI,IVRT,DT and E/A ratio were significantly improved 30 weeks after treatement as compared with those before treatment（P〈0.05）.The reduction ranges of systolic and diastolic BP were significantly larger in observation group（37±10 mm Hg,22±6 mm Hg,respectively） than in control（26±10 mm Hg,11±5 mm Hg,respectively）（P〈0.05）;the reduction ranges of LVMI,IVRT,DT（18±7 g/m^2,22±9 ms,90±18 ms,respectively） were larger than in control（14±6 g/m^2,18±7 ms,81±20 ms,respectively）;the extent of increase was larger in observation group（0.68±0.3） than in control（0.48±0.2）（P〈0.05）.Conclusion Both compound valsartan and valsartan treatments can reduce the BP levels of mild or moderate hypertensive patients and improve obviously left ventricular hypertrophy and diastolic function,but the former effects more remarkably.