坎地沙坦联合比索洛尔治疗高血压对左心室肥厚和心功能影响的临床观察

Clinical Observation on the Effects of Left Ventricular Hypertrophy and Cardiac Function of Candesartan Combined with Bisoprolol in Treatment of Hypertension

目的:探讨坎地沙坦联合比索洛尔治疗高血压,逆转左心室肥厚,改善心功能的作用。方法:将2014年1月-2016年2月本院心血管内科收治102例高血压并左室肥厚的患者随机分为坎地沙坦+比索洛尔组(A组)和吲达帕胺+比索洛尔组(B组),观察血压、超声心动图参数、心功能参数、不良反应等。结果:(1)两组治疗12个月后,收缩压与舒张压均有明显下降(P<0.01)。(2)A组治疗12个月后,左室舒张末期内径、左室后壁和舒张期室间隔厚度较治疗前均显著下降(P<0.05);B组治疗12个月后,左室后壁和舒张期室间隔厚度均无明显变化(P>0.05),左心室质量及质量指数均下降(P<0.05)。(3)A组患者治疗后的心排血量、左室射血分数、舒张早期与舒张晚期峰值流速的比值、E峰减速度均不同程度得到改善(P<0.05),B组治疗前后比较差异均无统计学意义(P>0.05)。结论:原发性高血压患者经坎地沙坦加比索洛尔治疗12个月后,可使其左室肥厚显著逆转并改善心功能。

Objective： To investigate the effects of Candesartan combined with Bisoprolol in the treatment of hypertension, improving the effect of left ventricular hypertrophy and cardiac function.Method： A total of 102 cases of hypertension and left ventricular hypertrophy were randomly divided into group A（ Candesartan combined with Bisoprolol ） and group B （ Indapamide combined with Bisoprolol ） from January 2014 to February 2016 in our hospital, blood pressure, echocardiographic parameters and cardiac function parameters, adverse reaction of two groups were observed.Result： （ 1 ） Systolic blood pressure and diastolic blood pressure in two groups were significantly decreased after treatment （ P〈0.01 ） . （ 2 ） After 12 months treatment, left ventricular end diastolic diameter, left ventricutar posterior wall and the interventricular septum thickness of group A decretased significantly （P〈0.05） .After 12 months treatment, the changes of wall and left ventricular diastolic ventricular septal thickness, left ventricular mass and quality of group B declined （ P〈0.05 ） . （ 3 ） After treatment, cardiac output, left ventricular ejection fraction, diastolic ratio, early and late diastolic peak velocity E peak deceleration of group A were improved to a certain extent （ P〈0.05 ）, there were no significant differences before and after treatment in group B （P〉0.05） .Conclusion： Patients with primary hypertension treated by Candesartan combined with Bisoprolol for 12 months, the left ventricular hypertrophy significantly reversed and improve cardiac function.