小剂量卡托普利、硝苯地平缓释片及美托洛尔联合降压改善左室舒张功能及左室重构的临床研究  

EFFECT OF COMBINATION OF ANTIHYPERTENSIVE PRESCRIPTION WITH LOW DOSE CAPTOPRIL,NIFEDIPINE SUSTAINED-RELEASE TABLETS AND METOPROLOL ON LEFT VENTRICULAR REMODELING AND DIASTOLIC FUNCTION

作　　者：英俊岐[1] 沈立[1] 冯亚彬[1] 种宝贵[1] 王歆月[1] 邱峰[2] 

机构地区：[1]河北医科大学附属哈励逊国际和平医院,河北省衡水市053000 [2]中国人民解放军海军总医院

出　　处：《中国心血管病研究》2004年第11期847-850,共4页Chinese Journal of Cardiovascular Research

基　　金：河北省科学技术攻关项目 (No .0 12 0 40D);河北省卫生厅科技指导项目 (No .0 3 192 )

摘　　要：目的　探讨小剂量卡托普利、硝苯地平及美托洛尔联合降压对左室舒张功能及左室重构的影响。方法　选择 192例高血压病患者随机分为复方降压片治疗组 (Ⅰ组 ) 95例和小剂量联合药物治疗组 (Ⅱ组 ) 97例 ,治疗前及治疗 6个月、12个月后测量血压 ,观测超声心动图左室舒张末内径 (LVD)、室间隔厚度 (IVS)、左室后壁厚度(LVPW )、左室重量指数 (LVMI)、E峰速度、A峰速度及A/E比值 ;根据有无左室肥大分成亚组 ,即无左室肥大Ⅰa亚组 6 2例、Ⅱa亚组 6 3例 ,有左室肥大Ⅰb亚组 33例 ,Ⅱb亚组 34例 ,治疗过程中 ,定期进行血压监测 ,并及时调整剂量。结果　①二组治疗 6个月、12个月后血压均较同组治疗前明显下降 ,组间同期比较差异无统计学意义 (P >0 .0 5 )。②Ⅰ组治疗 6个月后与治疗前A/E比值比较无明显改变 (P >0 .0 5 ) ,12个月时变化显著 (P <0 .0 5 ) ;Ⅱ组治疗前A/E值在治疗 6个月、12个月后比治疗前均有显著改善 (分别为P <0 .0 5和P <0 .0 1) ;治疗后A/E值 ,二组间同期比较均有统计学意义 (P <0 .0 5 )。③LVD、IVS、LVPW、LVMIⅠb亚组治疗前与治疗 6个月、12个月后比较无明显改变 (P >0 .0 5 ) ;Ⅱb亚组治疗 12个月后差异有统计学意义 (P <0 .0 1)。且 12个月后Ⅰb与Ⅱb亚组间差异亦有统计学意义 (PObjective To investigate the effect of combination of antihypertensive prescription with low dose captopril,nifedipine sustained-release tablets and metoprolol on left ventricular remodeling and diastolic function. Methods 192 patients were randomly divided into two groups of antihypertensive treatment:group 1,n=95,treated with compound reserpine and hydrochlorothiazide;group 2,n=97,treated with combination of antihypertensive prescription.The blood pressure,left ventricular end diastolic diameter(LVEDD),interventricular septum(IVS),left ventriculai posterior wall(LVPW),left ventricular mass index(LVMI),E,A and A/E ratio;Group 1 were divided into patients with left ventricular hypertrophy(LVH)(Ia,n=62) and those without LVH(Ib,n=33),group 2 was divided into patients with LVH(Ⅱa,n=63) and those without LVH(Ⅱb,n=34). Results ①Blood pressure was decreased significantly after 6 months and 12 months treatment in both groups.There was no significant difference between the two groups at the same period(P>0.05).②In group 1,A/E ratio changed significantly at 12 months(P<0.05),but did not at 6 months(P>05);in group 2,A/E ratio changed significantly both at months(P<0.05) and 12 months(P<0.01);A/E ratio was significantly different between the two groups at the same period(P<0.05).③Compared to the baseline,LVEDD,IVS,LVPW and LVMI in subgroup Ⅱb were obviously different at 12 months.④Cardiovascular event occurred more frequently in group 2(P<0.05). Conclusion Long term combination of antihypertensive prescription with low dose captopril,nifedipine sustained-release tablets and metoprolol can improve left ventricular diastolic function,reverse left ventricular remodeling and reduce cardiovascular event.

关 键 词：高血压病 左室肥厚 左室舒张功能 卡托普利 硝苯地平缓释片 美托洛尔 

分 类 号：R972.4[医药卫生—药品]