苯那普利和缬沙坦对原发性高血压患者心肌声学密度的影响  

Effect of the benazepril and valsartan on myocardial acoustic densitometry in essential hypertensive patients

作　　者：杜乃立[1] 杜瑞芝[1] 贾芳[1] 郝恩魁[1] 

机构地区：[1]山东大学临床医学院济南市中心医院心内科,济南250013

出　　处：《临床心血管病杂志》2007年第9期692-695,共4页Journal of Clinical Cardiology

摘　　要：目的:观察原发性高血压患者应用苯那普利和缬沙坦前后心肌声学密度各指标的变化情况,以探讨苯那普利和缬沙坦对高血压心肌纤维化的作用。方法:共入选原发性高血压患者75例(A组),随机分为3个亚组:A1组(25例),给予苯那普利10mg/d;A2组(25例),给予缬沙坦160mg/d;A3组(25例),给予苯那普利和缬沙坦半剂量合用(苯那普利5mg/d加缬沙坦80mg/d),均治疗6个月,并设立正常对照组(B组)75例。应用超声心动图测量心肌声学密度各项值:室间隔矫正的声学强度(CAI1)和左室后壁矫正的声学强度(CAI2)及室间隔背向散射积分周期变化值(CVIB1)、左室后壁背向散射积分周期变化值(CVIB2)。结果:A组的收缩压和舒张压显著高于B组,A1、A2、A3亚组用药后的收缩压和舒张压均显著低于用药前(均P<0.01);A组的CAI1、CAI2(0.88±0.06,0.73±0.06)显著高于B组(0.66±0.19,0.54±0.06)(P<0.01),而A组的CVIB1、CVIB2(6.07±0.85),(7.00±1.15)dB显著低于B组(8.60±3.12),(11.85±3.06)dB(均P<0.05);A1和A2亚组用药后CAI1、CAI2、CVIB1、CVIB2比较均差异无统计学意义(均P>0.05);A3组用药后CAI1、CAI2显著低于A1、A2组用药后(P<0.01),而A3组用药后CVIB1、CVIB2显著高于A1、A2组用药后(P<0.01;P<0.05)。结论:心肌声学密度各参数可用于评价高血压心肌纤维化,苯那普利和缬沙坦都减轻心肌纤维化,两者合用在减轻心肌纤维化方面效果更明显。Objective：To observe the alteration of myocardial acoustic densitometry in patients with essential hypertensive before and after taking benazepril and/or valsartan. Method： Seventy-five consecutive patients of essential hypertension （group A） were divided into three sub-group： group A1 （n=25）were given 10 mg/d benazepril for 6 months; group A2（n=25）were given 160 mg/d valsartan for 6 months; group A3 were given 5 mg/d banazepril ±80 mg/d valsartan for 6 months; 75 healthy persons were served as control group（group B）. The indicatrix of acoustic densitometry, including the calibrated acoustic intensity （CAI） and the cyclic variation of integrated backscatter （CVIB） with interventricular septum and left ventricular posterior wall, were evaluated by echocardiography. Result：The systolic and diastolic blood pressure of group A were significantly higher than those in group B（P〈0. 01）. After taken benazepril and/or valsartan, the blood pressure was significantly reduced（P〈 0.01）. The CAI1 and CAI2 in group A（0. 88±0. 06,0. 73±0. 06） were higher than those in group B（0.66±0. 19, 0.54±0.06）significantly（P〈0.01）, while CVIB1 and CVIB2 in group A（6.07±0.85） ,（7.00±1. 15）dB were lower than those in group B（8.60±3. 12） ,（11.85±3.06） dB significantly（P〈0.05） ; There were no differences in CAI1 ,CAI2 ,CVIB1 and CVIB2 between group A1 and A2（P〈0.05）. The CAI1 and CAI2 in group A3 were significantly reduced whereas the CVIB1 and CVIB2 increased compared with group A1 and A2 （P〈0. 01, P〈0.05, respectively）. Conclusion：myocardial fibrosis by the alteration of myocardial acoustic densitometry may be evaluated evaluae. Both benazepril and valsartan can reverse myocardial fibrosis in patients with essential hypertension, and the conbination of them is more effective.

关 键 词：高血压 心肌声学密度 心肌纤维化 

分 类 号：R544.1[医药卫生—心血管疾病]