噻嗪利尿剂联合ARB类药物治疗高血压并左室肥厚及左室舒张功能的临床研究

Clinical research of thiazide diuretic combined with ARB medication treatment for high blood pressure with left ventricular hypertrophy and ventricular end diastolic pressure function

目的:观察噻嗪利尿剂与ARB类药物联合治疗原发性高血压患者左室肥厚及左室舒张功能的疗效。方法:选取原发性高血压患者左室肥厚及左室舒张功能异常患者72例,并随机分为观察组36例,服用噻嗪利尿剂(氢氯噻嗪)和ARB类药物(厄贝沙坦);对照组36例单独服用ARB类药物(厄贝沙坦),两组治疗4周后,如果坐位舒张压≥12kPa或收缩压≥18.7kPa,剂量加倍,疗程均为6个月。结果:两组患者血压水平较治疗前明显下降(P<0.01);组间比较,观察组降压水平优于对照组(P<0.05)。两组患者的左室舒张功能指标、室间隔厚度、左室后壁厚度、左室重量及指数均明显降低(P<0.01),而左室射血分数明显升高(P<0.01)。结论:噻嗪利尿剂与ARB类药物联合使用不仅具有降压效果,还能更有效地改善左室肥厚和左室舒张功能,是临床可取的联合用药。

Objective:To observe the effect of thiazide diuretic combined with ARB medication treatment for high blood pressure with left ventricular hypertrophy and ventricular end diastolic pressure function.Methods:Chose 72 cases patients with high blood pressure with left ventricular hypertrophy and ventricular end diastolic pressure function,and randomly divided into observation group for 36 cases,was treated by thiazide diuretic(dihydrochlorothiazide) and ARB medication(irbesartan);and control group for 36 cases,too,was treated by the ARB medication(irbesartan) only,after 4 weeks,if the diastolic pressure≥12 kPa or systolic pressure≥18.7 kPa,when sit position,added doubling dosage,treated for 6 months.Results:The level of blood in two groups after treatment was lower than before(P<0.01),observation group was better than the control group(P <0.05),the index of ventricular end diastolic pressure function,interventricular septal thickness,posterior left ventricular wall thickness,left ventricular weight and index number in two groups were all lower than before(P<0.01),but the Left ventricular ejection fraction was highter than before(P<0.01).Conclusion:The thiazide diuretic and ARB medication use together,not only can low the blood,also can ameliorate the left ventricular hypertrophy and ventricular end diastolic pressure function,it's a better way to use together in the clinical.