伊贝沙坦与依那普利对高血压病左心室肥厚逆转作用的研究  

Clinical study Effect of Irbesartan combined with Enalapril on reversing left ventricular hypertrophy in patients with essential hypertension

作　　者：何月光[1] 罗炳辉[2] 张富娥[3] 赵先光[3] 迟伟[3] 

机构地区：[1]湖南永州职业技术学院医学院,425000 [2]永州市第三人民医院 [3]永州市人民医院心血管内科

出　　处：《中国实用医药》2007年第7期53-55,共3页China Practical Medicine

摘　　要：目的探讨伊贝沙坦与依那普利联合用药对原发性高血压(EH)病人左室肥厚(LVH)的逆转作用。方法EH伴有LVH病人106例随机分为A组(伊贝沙坦80mg/d,36例)、B组(依那普利10mg/d,35例)和C组(伊贝沙坦150mg/d,加依那普利10mg/d,35例)。治疗3周时若血压≥160/95mmHg,则伊贝沙坦和依那普利剂量分别增加1倍。总疗程共6个月,治疗前后24h动态血压监测和彩色超声多普勒检测左室相关指标,计算左室重量指数(LVMI)。结果①三组均能显著降低LVMI(P<0.01),其中A组和B组LVMI的降低差异无显著意义(P>0.05),C组LVMI降低较A组、B组更为显著、差异有显著意义(P<0.01)。②三组治疗前24h平均收缩压、平均舒张压差异无显著意义(P>0.05),治疗后24h平均收缩压、平均舒张压均较治疗前显著降低(P<0.01),但治疗后三组间比较均无明显差异(P>0.05)。结论伊贝沙坦、依那普利均能逆转EH病人LVH,联合用药疗效更为显著,这种协同作用与降压效应无关。Objective To study the effects of Irbesartan and Enalapril used individually or in combination on reversing left ventricular hypertrophy (LVH) in patient with essential hypertension (EH). MethodsA total of 106 patients with EH were divided randomly into three groups:Irbesartan group (150mg qd, n=36), benaxapril group (10mg qd, n=35) and combined treatment group (Irbesartan 80mg qd+Enalapril 10mg qd, n=35). If the blood pressure (BP)≥160/95mmHg was remained after 3 weeks treatment, then the dosees doubled. Treatment lasted for 6 months. LVMI was measured by heart Doppler ultrasound before and after treatment. The blood pressure was recordedby ABPM at same time. Results (1)After 6 months. LVMI was significantly less than that before treatment in the three groups (P<0.01). LVMI in the combined treatment group was less than that in the Irbesartan and Enalapril groups (P<0.01). No significant difference was found between Irbesartan and Enalapril groups (P>0.05). (2)Before treatment. 24h SBP and 24h DBP did not show significant diference respectively in the groups (P>0.05). After 6 months. 24h SBP and 24h DBP decreased more obviously than those before treatment (P<0.01), but did not show difference between the three groups (P>0.05). Conclusion Irbesartan combined with Enalapril has additive effect on reversing LVH in patients with EH, and this additive effect do not associate with decreasing blood pressure.

关 键 词：高血压 左心室肥厚 伊贝沙坦 依那普利 

分 类 号：R541.3[医药卫生—心血管疾病]