非洛地平对老年高血压左室肥厚与血压昼夜节律异常的影响

Effect of felodipine on left ventricular and abnormal circadian rhythm of blood pressure in senile patients with essential hypertension

目的 :观察老年高血压左室肥厚 (L VH)与血压昼夜节律关系和波依定治疗的效果。方法 :4 7例老年高血压伴 L VH患者治疗前行动态血压及超声心动图检测并与治疗后 8周的复查作比较。结果 :入选病例中 17例仍保存血压昼夜节律关系 ,消失者占 30例。消失组夜间血压 ,2 4小时平均收缩压、血压负荷、室间隔厚度 (IVST)、左室后壁厚度 (PWT)、左室重量指数(L VMI)、舒张晚期血流峰速 (AP)、等容舒张时间 (IRT)显著高于保存血压昼夜节律关系者 (P <0 .0 5 ) ,而舒张早期血流峰速比值 (EP/ AP)显著降低。治疗 8周后 30例血压昼夜节律消失者有 17例恢复正常节律 (5 6 .6 % ) ,其中 IVST、PWT、L VMI、AP、IRT等指标较治疗前显著下降 (P <0 .0 5～ 0 .0 1) ,EP/ AP显著上升。未逆转的 13例中仅 IVST下降。结论 :老年高血压伴 L VH者约有 6 3.8%患者有高血压昼夜节律消失 ,这些患者的夜间血压、2 4 h平均收缩压、舒张压及血压负荷值均明显高于正常节律组 ,及存在较重的左室肥厚及舒张功能减退。波依定治疗 8周能有效地降低血压和逆转左室肥厚 ,改善左室舒张功能 ,并使 5 6 .6

Objective:To study the effects of felodipine on older hypertension associated left ventricular hypertrophy and circadian rhythm of blood pressure Methods:Forty seven older patients of hypertension with LVH were selected for ABPM and UCG before and after felodipine taken Results:In the 47 cares of LVH,there were 30 cases with the loss of circadian rhythm in blood pressure(group A) and 17 cases with normal circadian variation(group B),n BP,24h SBP,SBP L,LVMI,AP,and IRT were higher in group A than that in group B;the maximal early peak velocity(EP)/AP was lower in group A than that in group B.After treatment,the CBP,24 BP L,LVMI,IVST,PWT,AP and IRT parameters were decreased,EP/AP parameter was increased than before treatment in the all EH patients.After treatment,circadian rhythm of blood pressure in 17 cases of group A had became to normal Conclusion:The occurrence rate of circadian rhythm loss in the blood pressure has reached 63 8% in the EH patients with LVH.The n BP,24h SBP,and SBP L increase significantly and impaired left ventricular diastolic function are found.Treatment with felodipine not only decrease blood pressure,but also regress LVH,improve left ventricular diastolic function,and ameliorate the blood pressure circadian rhythm