坎地沙坦联合卡维地洛治疗原发性高血压左室肥厚

Effects of candesartan combined with carvedilol on left ventricular hypertrophy of essential hypertension

目的:观察坎地沙坦联合卡维地洛治疗原发性高血压左室肥厚的疗效。方法:82例高血压患者被随机分为两组:观察组41例,予以坎地沙坦+卡维地洛;常规治疗组41例,予以氨氯地平+卡维地洛,共治疗12个月,观察用药后血压、左室结构的变化。结果:与治疗前比较,用药后两组收缩压[常规治疗组(166±14.0)mmHg∶(123±14.8)mmHg,观察组(168±14.5)mmHg∶(127±13.7)mmHg]和舒张压[常规治疗组(103±12.3)mmHg∶(76±13.6)mmHg,观察组(104±13.6)mmHg∶(79±13.2)mmHg]均显著降低(P均<0.05);两组治疗前后血压无显著差异(P均>0.05)。与治疗前比较,观察组室间隔厚度[(1.29±0.3)mm∶(1.12±0.2)mm]及左室后壁厚度[(1.21±0.2)mm∶(0.88±0.09)mm]均明显变薄(P均<0.05);左室重量指数[(138±27.9)g/m2∶(106±19.0)g/m2]明显减少(P<0.05),常规治疗组各项指标无明显变化(P>0.05),观察组较常规治疗组左室后壁厚度、左室重量指数显著改善(P均<0.05)。结论:坎地沙坦联合卡维地洛治疗原发性高血压左室肥厚患者,可安全有效降压,并同时逆转左室肥厚,改善左室舒张功能。

Objective：To observe the therapeutic effects of candesartan combined with carvedilol on left ventricular hypertrophy of essential hypertension（EH）.Methods：A total of 82 EH patients were randomly divided into two groups：observing group（n=41）,treated with candesartan and carvedilol;routine treatment group（n=41）,treated with amlodipine and carvedilol.Changes of blood pressure and structure of left ventricle were observed after drug treatment.Results：（1）After drug treatment,systolic blood pressure [SBP,（123±14.8） mmHg vs.（166±14.0） mmHg] and diastolic blood pressure [DBP,（76±13.6） mmHg vs.（103±12.3） mmHg] significantly decreased in routine treatment group compared with before treatment（P0.05 all）.In observing group,SBP [（127±13.7） mmHg vs.（168±14.5） mmHg] and DBP [（79±13.2） mmHg vs.（104±13.6） mmHg] also significantly decreased compared with before treatment（P0.05 all）.There were no significant difference between two group for SBP and DBP change（P0.05 all）.In observing group,interventricular septal thickness [TVST（1.12±0.2）mm vs.（1.29±0.3）mm],left ventricular posterior wall thickness [LVPWT（0.88±0.09）mm vs.（1.21±0.2）mm] and left ventricular mass index [LVMI（106±19.0）g/m2 vs.（138±27.9） g/m2] significantly decreased（P0.05 all） compated with befare treatment,and LVPWT、LVMI were less than those of routine treatment group（P0.05 all）,but those indicators had no significant change after treatment in routine treatment group（P0.05）.Conclusion：For patients with essential hypertension and left ventricular hypertrophy,combined treatment with candesartan and carvedilol can lower their blood pressure safely and effectively,and reverse left ventricular hypertrophy.