厄贝沙坦对高血压左室肥厚的疗效及心功能影响

Effect of irbesartan on left ventricle hypertrophy and cardiac function in patients with essential hypertension

目的观察厄贝沙坦治疗轻中度高血压的降压效果、逆转左室肥厚及改善心功能的疗效。方法将76例原发性高血压并左室肥厚患者随机分为厄贝沙坦组(A组)和氨氯地平组(B组),观察血压,并作多普勒超声心动图检测。结果 (1)两组治疗6个月后,收缩压与舒张压均有明显下降,A组由155/98mmHg(1mmHg=0.133kPa)降至136/87mmHg;B组由156/99mmHg降至138/88mmHg,均(P<0.01),A组血尿酸明显下降。(2)A组治疗6个月后,左室舒张末期内径、左室后壁与舒张末期室间隔厚度较治疗前下降(均P<0.05),左室重量及左室重量指数下降显著(均P<0.01);而在B组治疗6个月后左室舒张末内径与室间隔厚度、左室重量及左室重量指数有所下降(P<0.05)。A组与B组比较左室重量及左室重量指数下降更明显(均P<0.05)。(3)厄贝沙坦组患者治疗后的心排血最、左室射血分数、舒张早期与舒张晚期峰值流速的比值均得到改善,氨氯地平组治疗前后差异无统计学意义。结论原发性高血压患者经坎地沙坦及氨氯地平治疗后,均能不同程度降低血压并逆转左室肥厚,厄贝沙坦明显逆转左室肥厚并改善心功能。

Objective To study the efficacy of Irbesartan in lowering hypertension,reversing left ventricle hypertrophy and improving cardiac function.Methods Seventy six patients were randomized into the Irbesartan group or Amlodipin group,after observed blood pressure,All patients were measured by echocardiography.Results （1）Six months after treatment with Irbesartan or Amlodipin,blood pressure was reduced from 155/98 to 136/87 mm Hg（P0.01）or from 156/99 to 138/88 mm Hg（P0.01）.（2）Left ventrieular hypertrophy（LVH）,left ventricular posterior wall thickness（PWT）,ventricular septal thickness（VST）were reversed,the left ventricular mass（LVM） and the left ventricular mass index（LVMI）was obviously reduced after treatment with Irbesartan（P0.01）.LVH,VST,LVM and LVMI were reduced after treatment with Amlodipin（P0.05）.LVM and LVMI in group A were significantly lower（P0.05）.（3）Irbesartan also effectively improved cardiac function,cardiac output（CO）,left ventrieular ejectio fraction（LVEF）,early diastolic peak flow velocity in the late diastolic ratio（E/A）,in Amlodipin group there was no significant difference before and after treatment.Conclusion Irbesartan and Amlodipin can effectively reduce blood pressure,and reverse left ventricular hypertrophy as well.Irbesartan significantly reverse left ventricular hypertrophy and improve the left ventricular function.