非洛地平和替米沙坦单用及两药联用对中老年高血压的疗效和对左室肥厚的逆转作用

Effects of felodipine,telmisartan and their combined usage on hypertension and left ventricular hypertrophy in middle-aged and elderly patients

目的探讨非洛地平与替米沙坦对中老年高血压的疗效和对左室肥厚的逆转作用。方法将2级原发高血压伴有左室肥厚中老年患者93例随机分成A组(非洛地平5mg/d+替米沙坦80mg/d,n=31)、B组(非洛地平5mg/d,n=31)和C组(替米沙坦80mg/d,n=31),住院及出院后随访观察12周,每天测血压及治疗前后用彩色超声多普勒检测心室重构的各项指标。结果治疗后三组收缩压、舒张压均较治疗前明显降低,差异均有统计学意义(t分别=14.45、10.31、10.80、5.80、4.05、4.22,P均<0.05),尤以A组收缩压降低明显,与B、C组比较,差异均有统计学意义(t分别=-3.19、-2.09,P均<0.05)。三组治疗后舒张末期左室内径(LVEDd)、舒张末期室间隔厚度(IVSd)、舒张末期左室后壁的厚度(LVPWd)和左室重量指数(LVMI)均较治疗前明显下降,差异均有统计学意义(t分别=2.95、2.09、2.08、4.19、5.59、2.13、17.71、6.91、6.12,P均<0.05),其中A组LVEDd、LVMI较B、C组比较,差异均有统计学意义(t分别=-2.23、-2.76、-7.21、-7.91,P均<0.05)。结论非洛地平、替米沙坦均能降低血压并改善心室重构,两者联用效果更为明显。

Objective To investigate the effects of felodipine and telmisartan on the hypertension and left ventricular hypertrophy of the middle-aged and elderly population.Methods A total of 93 patients with secondary hypertension associated with left ventricular hypertrophy were divided randomly into three groups：A group（felodipine 5mg/d ＋ telmisartan 80mg/d,31 cases）,B group（felodipine 5mg/d,31 cases）and C group（telmisartan 80mg/d,31 cases）.They were observed for 12 weeks during hospitalization and follow-up.The blood pressure was measured everyday and the indexes of ventricular remodeling were detected before and after treatment by color Doppler ultrasonography.Results ①Systolic and diastolic blood pressures in all the 3 groups significantly decreased after treatment（t=14.45,10.31,10.80;5.80,4.05,4.22,P0.05）.The systolic blood pressure in the A group was significantly lower compared with that of B and C groups（t=-3.19,-2.09,P0.05）.②The left ventricular end-diastolic diameter（LVEDD）,end-diastolic interventricular septum thickness（IVSD）,end-diastolic left ventricular posterior wall thickness（LVPWD） and left ventricular mass index（LVMI） in all the three groups significantly decreased after treatment（t=2.95,2.09,2.08;4.19,5.59,2.13;17.71,6.91,6.12,P 0.05）.Compared with B,C groups,the LVEDD and LVMI in group A were significantly lower（t=-2.23,-2.76;-7.21,-7.91,P0.05）.Conclusions Felodipine and telmisartan can decrease blood pressure and ameliorate left ventricular remodeling,and the effect of combined usage is more visible.