不同类型钙拮抗剂对高血压患者左心室肥厚的逆转作用

EFFECTS OF CACLIUM BLOCKADE ON HYPERTENSIVE LEFT VENTRICULAR HYPERTROPHY

以单盲法观察钙拮抗剂地尔硫(艹卓)(硫氮(艹卓)酮)、硝苯地平(硝苯吡啶)及尼群地平对高血压病患者左心室肥厚的逆转作用。服药8～10个月,三种药物均使患者的平均室间隔、左室后壁厚度及左室重量指教下降。其中地尔硫(艹卓)的作用最强,硝苯地平和尼群地平的作用相似,但不及地尔硫(艹卓)明显。三种药物均不影响左心收缩功能,但均能使舒张功能改善。

The effects of three calcium blockers namely diltiazem, nifedipine and nitrendipine on hypertensive left ventricular hypertrophy (LVH) were studied by M-mode and Doppler echocardiography. 108 patients with essential hypertension were divided randomly into three groups, one for each drug. Blood pressure, inter-ventricular septum thickness (IVST), posterior wall thickness (PWT) and LV mass index (LVMI) decreased significantly in all the three groups after administration of drugs for 9.3-9.6 months. The decrement of IVST and LVMI in diltiazem group were significantly greater than those in both nifedipine and nitrendipine groups. The left ventricular ejection fraction and circumferential fiber shortening fraction remained unchanged. But the mean early peak filling velocity (E) and early to late peak filling velocity ratio (E/A) of left ventricle increased significantly in all groups. The results indicate that the regression of LVH caused by diltiazem is superior to that caused by both nifedipine and nitrendipine. Diastolic function of the left ventricle was improved by these calcium blockers while the systolic function was unaffected.