厄贝沙坦对高血压患者左室肥厚和心率变异性的疗效

Therapeutic effect of irbesartan on left ventricular hypertrophy and heart rate variability in patients with essential hypertension

目的:研究厄贝沙坦对原发性高血压患者左心室肥厚和心率变异性的疗效。方法:选择203例高血压患者作为研究对象,随机分为常规治疗组[101例,患者服用常规降压药(包括β受体阻滞剂类,钙离子拮抗剂类和利尿剂)]和厄贝沙坦组(102例,在常规治疗组基础上加用厄贝沙坦),6个月后比较两组患者治疗前后的血压、左心室肥厚和心率变异性情况。结果:治疗后,两组患者的血压均较治疗前明显降低,但两组间无统计学差异(P>0.05);与常规治疗组比较,厄贝沙坦组患者的左室后壁厚度[LVPWT,(10.1±0.7)mm比(9.3±0.8)mm],左室舒张末期内径[LVEDd,(47.3±1.7)mm比(45.1±1.1)mm]、室间隔厚度[IVST,(12.1±0.8)mm比(10.7±0.5)mm]均明显减小(P均<0.05),24h窦性R-R间期标准差[SDNN,(107.5±2.9)ms比(119.4±3.5)ms]、24h每5min正常R-R间期平均值的标准差[SDANN,(98.3±1.5)ms比(102.3±1.9)ms]、相邻RR间期差值的平方根[rMSSD,(32.8±0.7)ms比(34.7±0.9)ms],相邻正常R-R间期差值>50mz的窦性心率数占心搏总数的百分比[PNN50,(7.3±0.2)%比(8.1±0.5)%]均明显增加(P均<0.05)。结论:联用厄贝沙坦可以有效控制血压,改善左心室肥厚和心率变异性。

Objective:To study therapeutic effect of irbesartan on left ventricular hypertrophy(LVH)and heart rate variability(HRV)in patients with essential hypertension(EH).Methods:A total of 203 EH patients were enrolled and randomly divided into routine treatment group[n=101,received routine antihypertensive drugs,includingβ-receptor blocker,calcium channel blocker and diuretics]and irbesartan group(n=102,received irbesartan based on routine treatment group).After six-month treatment,blood pressure,LVH and HRV indexes were compared between two groups before and after treatment.Results:Compared with before treatment,there were significant reductions in blood pressure level in both groups after treatment,and there were no significant difference between two groups,P>0.05;compared with routine treatment group,there were significant reductions in left ventricular posterior wall thickness[LVPWT,(10.1±0.7)mm vs.(9.3±0.8)mm],left ventricular end-diastolic diameter[LVEDd,(47.3±1.7)mm vs.(45.1±1.1)mm]and interventricular septal thickness[IVST,(12.1±0.8)mm vs.(10.7±0.5)mm],P<0.05all;and significant rise in standard deviation of normal to normal RR intervals calculated over the 24 hperiod [SDNN,(107.5±2.9)ms vs.(119.4±3.5)ms],standard deviation of normal to normal RR intervals in all 5min segments of the entire recording [SDANN,(98.3±1.5)ms vs.(102.3±1.9)ms],root-mean square of differences between successive normal to normal intervals[rMSSD,(32.8±0.7)ms vs.(34.7±0.9)ms]and adjacent normal RR interval difference>50ms stroke accounted for apercentage of 24 htotal RR interval [PNN50,(7.3±0.2)% vs.(8.1±0.5)%]in irbesartan group,P<0.05 all.Conclusion:Combined Irbesartan and rouline antilhtpertensive drugs is effective in controlling blood pressure,and it can improve left ventricular hypertrophy and heart rate variability.