乌拉地尔降压作用及逆转左室不良重塑的研究

A study of the effect of urapidil in decreasing blood pressure and reversing bad left ventricular remodelling

目的观察乌拉地尔降压及改善心功能与逆转左室不良重塑的作用。方法选择存在左心室肥厚 级、 级高血压患者 6 0例 ,对其服用乌拉地尔前后记录 2 4小时动态血压 ( 2 4ABP) ;测左室收缩、舒张功能及室间隔厚度、左室后壁厚度 ( LVPWD)、左室重量指数( L VMI)进行对比分析。结果 2 4小时平均收缩压及舒张压 ( 2 4MSP和 2 4MDP) ,白昼、夜间平均收缩压及舒张 ( d MSP,MPD;n MSP,n MDP)压均明显下降 ( P<0 .0 1) ;降压谷 /峰比值均大于 6 0 % ;LVMI下降 ( P<0 .0 1) ) ;左室舒张功能有显著改善 ,左室收缩功能改善较小 ( P<0 .0 0 1,P>0 .0 5 )。结论乌拉地尔降压疗效可靠 ,对改善左室舒张功能与逆转左室不良重塑有明显作用 ;副作用小 。

Objective To observe the effect of urapidil in decreasing blood pressure,improving cardiac function and reversing bad left ventricular remodelling.Methods 60 patients with Ⅱ and Ⅲ grade hypertension as well as left ventricular hypertrophy were chosen to record ambulatory blood pressure before and after being given urapidil.The left ventricular systolic and diastolic function,interventricular septal thickness (IVST),left ventricular posterior wall thickness (LVPWT) and left ventricular mass index (LVMI) were measured for comparison.Results 24h mean systolic pressure (MSP),24h mean diastolic pressure (MDP),dMSP,dMDP,and nMSP as well as nMDP were decreased(P<0.01).The trough to peak ratios of systolic and diastolic blood pressures was all above 60%.The LVMI was decreased significantly(P>0.05).The left ventricular diastolic function was improved greatly(P<0.01), but there was no significant change in diastolic function.Conclusion Urapidil is reliable in the treatment of hypertension and effective in the improvement of the left ventricular systolic function and reversal of bad left ventricular remodelling,with little side effects,which can be used for the hypertension at every stage.