咪达普利和缬沙坦联合治疗对原发性高血压患者左心室肥厚的逆转探讨

The reversal of left ventricular hypertrophy in patients with essential hypertension by imidapril and valsartan combined therapy

目的分析咪达普利和缬沙坦联合治疗对原发性高血压患者左心室肥厚的逆转作用。方法选取本院于2014年2月—2015年2月期间入院的、接受左心室肥厚治疗的原发性高血压患者77例,随机分组,一组单纯使用咪达普利进行治疗(参照组,共有38例),而另一组使用咪达普利和缬沙坦联合治疗(研究组,共有39例)。其中参照组服用咪达普利10 mg/d,依据患者的病情变化进行调整。以10 mg/d的咪达普利以及80 mg/d的缬沙坦对研究组患者进行治疗,依据患者的病情变化进行调整。观察患者的LVMI、心率、肌酐、血钾、血压水平变化,计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果研究组的HR为(67.72±9.88)次/min,LVMI为(122.43±19.88)g/m2,参照组的HR为(73.18±10.54)次/min,LVMI为(134.98±21.34)g/m2,研究组HR、LVMI与参照组比较差异均有统计学意义(均P<0.05)。研究组的收缩压治疗前为(158.34±14.88)mm Hg(1 mm Hg=0.133 k Pa),治疗后为(122.09±10.32)mm Hg,舒张压治疗前为(98.47±10.50)mm Hg,治疗后为(79.16±6.45)mm Hg,参照组的收缩压治疗前为(157.41±14.25)mm Hg,治疗后为(125.13±12.33)mm Hg,舒张压治疗前为(98.23±10.12)mm Hg,治疗后(80.49±6.82)mm Hg,治疗前后对比差异均有统计学意义(均P<0.05)。结论咪达普利和缬沙坦联合治疗能逆转原发性高血压患者的左心室肥厚,值得推广应用。

Objective To analyze the imidapril and valsartan on reversal of left ventricular hypertrophy in essential hypertension patients.Methods In our hospital, we chose patients treated of left ventricular hypertrophy and from February 2014 to February 2015 during the admission of primary hypertension,77 eases.According to the odd and even of the diagnosis and treatment of the sequence of packets,a group of 38 patients were treated with imidapril（the reference group,38 cases）,while the other group was treated with imidapril and valsartan（the study group,39 cases）.The reference group was treated with 10 mg/d ,according to the pa- tients＇ condition changes.The study group was treated by 10 mg/d imidapril and valsartan in patients with 80 mg/d,aceording to the changes of patients＇ eondition.LVMI,HR,creatinine,serum potassium and blood pressure were observed in the patients.the count data were processed by chi square test,measurement data by t test,when P〈0.05 means statistical differences were signifi- cant.Results The HR of the study group was （67.72 ± 9.88） times/min,LVMl was （122.43-± 19.88） g/m2,HR of the reference group was （73.18 ± 10.54） times/min,LVMI was （134.98 ± 21.34） g/m2,HR,LVMI of reference group were significantly higher than the study group（all P〈0.05）.The systolic blood pressure in study group was （158.34 ± 14.88）mm Hg before the treatment,（122.09 ± 10.32）ram Hg after treatment,and （157.41 ± 14.25）,（125.13 ± 12.33 ）mm Hg in the reference group,the differences were signifi- cant（all P〈0.05）.The diastolic blood pressure of the study group was （98.47± 10.50）mm Hg before the treatment,（79.16 ± 6.45）mm Hg after treatment,and （98.23 ± 10.12）,（80.49± 6.82）mm Hg in the reference group,the differences were significant（all P〈0.05）.Conclusion Imidapril and valsartan combined treatment of left ventricular hypertrophy in patients with essential hypertension is good.lt is worthy of popularization and application.