老年高血压左室肥厚QT离散度变化及药物干预

DRUG THERAPY AND CHANGE OF QT DISPERSION IN THE AGED HYPERTENSION WITH VENTRICULAR HYPERTROPHY

目的 :观察老年高血压左室肥厚 (L VH) QT离散度变化及转换酶抑制剂治疗后 QT离散度 (QTd)的改变。方法 :10 1例住院老年高血压患者 ,经用超声心动图检查确诊 L VH30例 ,作为 A组 ;随机取无 L VH30例 ,作为 B组 ,全部病人给予依那普利或卡托普利治疗 6个月 ,每日测血压、心率 ,于治疗前、治疗后做超声心动图 ,2 4 h动态血压及体表心电图检查。结果 :1L VH组 (A组 )的 QTd和校正后的 QT离散度 (QTcd) ,明显大于无 L VH组 (B组 ) (P <0 .0 5 ) ;2治疗后两组病人收缩压 (SBP)、舒张压 (DBP)明显下降 (均 P <0 .0 5 ) ;3治疗 3,6个月后随左室质量指数 (L VMI)下降的同时 ,QTd和 QTcd也明显缩短 (P <0 .0 5 )。结论 :1A组 QTd、QTcd大于 B组 ;2依那普利或卡托普利能明显降低老年高血压的SBP和 DBP,逆转 L VH;3在 L VH逆转及左室功能改善的同时 QTd、 QTcd亦随之缩小。

Objective:To investigate the change of QT dispersion in left ventricular hypertrophy of the aged hypertension(LVH) and the change of QT dispersion after ACEI treatment Methods:101 aged hypertensive cases,30 cases were diagnosed as LVH by color Doppler echocardiography in group A,the rest(30 cases) without LVH in B group All patients took Captopril or Enalapril for 6 months before treament,and all patients were examined by color Doppler echocardiography and ECG for the first time,and examined again after the treatment Results:①It is very clear that QTd and QTcd of A group were higher than those of group B (P<0 05) ②After the treatment,SBP,DBP decreased significantly(P<0 05) in both groups ③After treatment,the LVMI decreased,QTd and QTcd of the two groups were significantly reduced(P<0 05) Conclusions:Enalapril or Captopril can significantly decrease SBP and DBP of the aged hypertensives,LVH and QTd QTcd were also reduced