缬沙坦与吲达帕胺治疗原发性高血压的对比研究

Contrast Study of Valsartan and Indapamide in Treatment of Essential Hypertension

目的 :评价缬沙坦 (valsartan)降压疗效的同时 ,探讨其降压外的其它作用。方法 :入选的原发性高血压患者被随机分为缬沙坦组和吲达帕胺 (indapamide)组。用药前后进行诊所血压、心脏超声多普勒及血浆一氧化氮 (NO)、血管紧张素Ⅱ (AngⅡ )、血浆醛固酮、空腹胰岛素及血脂 ,血清尿酸、血电解质、空腹血糖、肝肾功能及血尿常规检查 ,并计算空腹胰岛素 /空腹血糖值作为胰岛素抵抗指标。对已婚男性患者进行关于性功能障碍的问卷调查。结果 :治疗后 ,缬沙坦组和吲达帕胺组血压均有所下降 ,降压疗效相似 (总有效率分别为 6 7 5 %和 6 6 7% ) ,左心房指数均改善 ,有显著性差异 (P <0 0 5 ) ,舒张功能指标 (A/E)好转 ,有显著性差异 (P <0 0 1和P <0 0 5 ) ;缬沙坦组患者的AngⅡ和NO均升高 ,有显著性差异 (P <0 0 5和P <0 0 1) ,空腹胰岛素 /空腹血糖值降低 ,有显著性差异 (P <0 0 1) ,左心室心肌重量指数减低 ,有显著性差异 (P <0 0 5 ) ;此外 ,缬沙坦组患者的性活动增加 ,有显著性差异 (P <0 0 5 )。结论 :除了确切而缓和的降压作用外 。

Objective:To evaluate the antihypertensive effects of valsartan and to seek its other effects in addition to the lowering of blood pressure. Methods:All patients with essential hypertension were randomly divided into valsartan group and indapamide group.The office blood pressure,echocardiography,serum nitric oxide(NO),angiotensin Ⅱ(Ang Ⅱ),serum aldosterone,lipids,serum uric acid,electrolyte,fasting blood glucose(FBG),fasting insulin(Flns),liver function,kidney function,routine blood test and routine urine test were examined before and after treatment.Insulin resistance(IR)was expressed by the ratio of Flns to FBG(Flns/FBG).Questionnaire on sexual function was made in married males before and after treatment. Results:After 8 weeks of treatment,the total response rates in both groups were similar(67.5% versus 66.7%).Left atrial diameter index was improved markedly (p<0.05 respectively). The ratio of the peak velocity of late filling to that of early filling (A/E) was decreased obviously (p<0.01 and p<0.05 respectively) in both groups.In valsartan group.Ang Ⅱ and serum NO were increased (p<0.05 and p<0.01),IR improved (p<0.01) and left ventricular mass index (LVMI) reduced (p<0.05).The frequency of sexual intercourse was increased markedly after valsartan treatment (p<0.05). Conclusions:Valsartan has a good compliance and protective effect for target organs in addition to its reliable and moderate decrease in blood pressure.