依那普利对高血压病左心室肥厚患者QT离散度的影响

Effect of enalapril on QT dispersion in essential hypertension patients with left ventricular hypertrophy

目的 研究长期使用依那普利治疗高血压病合并左心室肥厚时对QT离散度的影响。方法 2 4例高血压病 (EH)合并左心室肥厚 (LVH)者 ,服用依那普利 (10mg 1次 /d) 3年 ,用标准 12导联心电图测量QT间期、校正的QT间期 (QTc)、QT间期离散度 (QTd)及校正的QT间期离散度 (QTcd) ;用二维及M型超声心动测定有关心血管参数。结果 依那普利不仅能迅速降压 ,而且能逐渐降低左心室重量指数 (LVMI)达 3 9% (P <0 .0 0 1) ,显著提高左心室泵血功能 ;同时明显缩短QTd[从 (61± 2 1)到 (41± 15 )ms、QTcd从 (67± 2 7)到 (46± 18)ms] ,QT及QTc也同样明显缩短。结论 长期用依那普利治疗EH合并LVH ,能明显使患者左心室肥厚回缩 ,提高其左心室收缩功能 ,并通过降低QTd及QTcd ,进一步降低室性心律失常发生率 ,从而改善预后。

Objective To study the evolution of QT and QTc dispersion in patients who received long-term treatment with enalapril for essential hypertension with left vertricular hypertrophy.Methods 24 cases of essential hypertension (EH) with left ventricular hypertrophy (LVH) took enalapril (10mg once daily ) for 3 years. By using standard 12-lead electrocardiagrams we measured QT interval(QT) and corrected QT interval (QTc) and their dispersion. Using two dimensional guided M-mode echocardiography we determined cardiovascular parameters.Results Enalapril could reduce blood pressure rapidly. It not only made left ventricular mass (LVM) decresed reaching 39%(P<0.001),and improved LV pump function, but also made QT and QTc dispersion decreased significantly[from(61±21) to (41±15) ms; from (67±27) to (46±18) ms respectively].Conclusion Long-term enalapril treatment of hypertensive patients with LV hypertrophy not only induce marked regression of LVM and improved LV systolic function, but also reduces the dispersions of QT and QTc, which probably reduces the likelihood of ventricular arrhythmias and improves prognosis.