缬沙坦与依那普利对高血压患者QT间期离散度与室性早搏的疗效

Therapeutic effect of valsartan and enalapril on QT interval dispersion and premature ventricular contraction in patients with hypertension

目的:比较缬沙坦与依那普利对高血压患者QT间期离散度(QTcd)与室性早搏的疗效。方法:选择来我院就诊的110例原发性高血压患者,采用随机数字表法均分为缬沙坦组和依那普利组,比较两组患者QTcd和室性早搏情况。结果:治疗后两组患者QT间期、校正QT间期(QTc)、QTcd均较治疗前明显降低(P均<0.01),且与依那普利组比较,缬沙坦组QT间期[(389.45±55.85)ms比(339.58±50.58)ms]、QTc[(366.58±48.98)ms比(319.58±46.58)ms]、QTcd[(34.55±5.08)ms比(21.85±3.87)ms]降低更明显(P均<0.01)。治疗后两组患者收缩压、舒张压、室性早搏次数均明显低于治疗前(P均<0.01),但是两组血压无显著差异(P>0.05),缬沙坦组室性早搏的次数明显少于依那普利组[(619.85±202.45)次/d比(949.55±198.85)次/d,P=0.001]。缬沙坦组室性早搏发生情况与收缩压、舒张压和左室心肌质量指数没有显著相关性(r=0.101,0.089,0.104,P均>0.05),而依那普利组室性早搏发生与收缩压、舒张压和左室心肌质量指数呈明显正相关(r=0.631,0.599,0.591,P均<0.05)。两组均无明显不良反应。结论:缬沙坦能够明显降低高血压患者QT离散度和血压,减少室性早搏的发生率,效果比依那普利好,值得临床使用推广。

Objective： To compare therapeutic effect of valsartan and enalapril on QT interval dispersion （QTcd） and premature ventricular contraction in patients with hypertension. Methods： A total of 110 patients with essential hypertension were selected from our hospital. According to random number table, they were randomly and equally divided into valsartan group and enalapril group. QTcd and arrhythmia were compared between two groups. Results： Compared with before treatment, there were significant reductions in QT interval, corrected QT interval （QTc） and QTcd in both groups after treatment （P〈0.01 all） ; compared with enalapril group, there were significant reductions in QT interval [- （389.45 ± 55.85） ms vs. （339.58 ± 50.58） ms], QTc [ （366.58 ± 48.98） ms vs. （319.58 ± 46.58） ms] and QTed [（34. 55 ± 5.08） ms vs. （21.85 ± 3.87） ms] in valsartan group, P（0.01 all. Compared with before treatment, there were significant reductions in SBP, DBP and premature ventricular contraction times （PVCT） in both groups after treatment （P（0.01 all）, but there were no significant difference in SBP and DBP （P 〈0.05 both） between two groups, PVCT of valsartan group was significantly fewer than that of enalapril group [ （619.85 ± 202.45） times/d vs. （949.55 ± 198.85） times/d, P = 0. 001]. In valsartan group, there was no signifi- cant correlations among SBP, DBP, left ventricular myocardial mass index （LVMI） and premature ventricular con- traction （r = 0. 101, 0. 089, 0. 104, P〉0.05 all）; while in enalapril group, occurrence of premature ventricular contraction was significant positively correlated with SBP, DBP and LVMI （r = 0. 631, 0. 599, 0. 591, P〈0.05 all）. No severe adverse reactions occurred in either group. Conclusion： Valsartan can significantly reduce QT interval dispersion, blood pressure and incidence rate of premature ventricular contraction in patients with hypertension. The therapeutic effect is better than that of enalapril, which is worth extending.