血管紧张素Ⅱ受体拮抗剂对原发性高血压患者左心室肥厚和舒张功能的影响

Effect of angiotensin Ⅱ antagonist on left ventricular hypertrophy and diastolic function in patients with essential hypertension

目的 应用超声心动图评价血管紧张素 1型受体 ( AT1 )拮抗剂对原发性高血压患者左心室肥厚和舒张功能的影响。方法 分别于 AT1 拮抗剂 (氯沙坦 )治疗前和治疗 6个月后 ,对 3 0例原发性高血压患者进行超声心动图检查。 M型超声心动图测量舒张末期左心室内径、室间隔和左心室后壁厚度 ,计算左心室重量指数 ;在心尖左心长轴切面上 ,用多普勒超声心动图测量二尖瓣口舒张早期峰值速度 E、舒张晚期峰值速度 A和 E峰减速时间 ,并计算E/A比值。结果 氯沙坦治疗 6个月后 ,左心室重量指数从 12 4± 2 1g/m2减低为 10 2± 2 2 g/m2 ( P<0 .0 0 1) ;E/A比值 ( 1.2 5± 0 .2 7)明显高于服用前 ( 0 .94± 0 .2 6,P<0 .0 0 1) ,E峰减速时间从 2 2 1± 3 2 ms下降到 180± 2 7ms( P<0 .0 0 1)。结论 AT1 拮抗剂氯沙坦治疗 6个月使原发性高血压患者左心室肥厚得到消退 。

Objective To evaluate the effect of angiotensinⅡ type 1 receptor antagonist on left ventricular hypertrophy and diastolic function in patients with essential hypertension. Methods Left ventricular end diastolic dimension, end diastolic septal thickness and end diastolic posterior wall thickness were measured before and after 6 months of losartan treatment in 30 hypertension patients by M mode echocardiography. Pulsed Doppler echocardiographic recordings of transmitral flow velocity were obtained. Peak velocity in early diastole(E) and at atrial contraction(A) and mitral valve E peak deceleration time were measured. E/A was calculated. Results After 6 months of losartan administration, left ventricular mass index reduced significantly from 124±21g/m 2 to 102±22g/m 2 ( P <0.001). The ratio of peak velocity in early diastole to that at atrial contraction(E/A) increased significantly from 0.94±0.26 to 1.25±0.27 ( P <0.001), and mitral valve E peak deceleration time decreased significantly from 221±32 ms to 180±27 ms( P <0.001). Conclusion Treatment with angiotensin Ⅱtype 1 receptor antagonist losartan for 6 months regressed the left ventricular hypertrophy and improved the diastolic function in patients with essential hypertension.