氯沙坦改善原发性高血压患者左心功能疗效观察  

Clinical observation on left heart function in essential hypertensive patients treated with Losartan

作　　者：王林全[1] 李杰[1] 吴绥生[1] 

机构地区：[1]吉林大学第一临床医院干部病房,长春130021

出　　处：《中国综合临床》2008年第4期299-301,共3页Clinical Medicine of China

基　　金：吉林省卫生厅资助课题（9731）

摘　　要：目的观察氯沙坦对原发性高血压患者血流动力学和左心功能的影响。方法43例原发性高血压患者（氯沙坦组）服用氯沙坦50-100mg/d12～17个月，另选择20例原发性高血压患者服用复方降压片作为对照组，观察治疗前、后血流动力学指标和左心功能的变化。结果氯沙坦组服用氯沙坦12～17个月后血压明显下降（P〈0．001），全血低切粘度（ηb）、血浆粘度（ηp）及红细胞聚集指数（AI）、全血低切还原粘度、红细胞电泳、纤维蛋白原（Fib）均显著降低（均P〈0．01）；全血高切粘度、全血高切还原粘度、红细胞比容和红细胞刚性指数（RRI）也有所下降，但无统计学意义（均P〉0．05）；左心室质量（LVM）、左心室质量指数（LVMI）均较治疗前明显减小（P〈0．01或0．05），舒张早期充盈速度／晚期充盈速度（E／A）较治疗前增加（P〈0．01），等容舒张时间（IRT）较治疗前缩短（P〈0．05）。而对照组服药前后上述指标差异均无统计学意义（均P〉0．05）。结论原发性高血压患者服用氯沙坦后在血压显著降低的同时，其红细胞聚集性、Fib下降和红细胞变形能力增强，红细胞比容、血粘度降低，从而减轻了心肌肥厚，使心脏质量减轻，改善心功能。Objective To investigate the clinical effects of Losartan on hemorrheology and left heart function in essential hypertensive patients. Methods 43 essential hypertensive patients were treated with Losartan,50 mg/d - 100 mg/d for twelve to seventeen months. 20 essential hypertensive patients were treated with Fu Fang Jiang Ya Pian as control group. Then the changes of hemorrheology indexes and left heart function were tested in both groups. Results After the treatment with Losartan the blood pressure reduced effectively （ P 〈 0. 001 ）, the whole blood low shear rate hyperviscoSity （ ηb） , plasma viscosity, AI, whole blood low shear rate reduced viscosity, erythrocyte electrophoresis, Fib reduced obviously （P 〈 0.01 ） ,but the control group had not statistical significance （P 〉 0.05） before and after treatment. The whole blood high shear rate hyperviscosity, whole blood high shear rate reduced viscosity, Hct, RRI reduced too（ P 〉0.05 ） ,but there was no statistical significance. LVM（ P 〈0.01 ） and LVMI（ P 〈 0. 05 ） were obviously reduced, E/A was increased （ P 〈 0. 01 ） , IRT （ P 〈 0. 05 ） was shorten （P 〈0.05 ） ,while the cardiac diastole function improved effectively. The significant differences were not observed in the control group pre and post treatment （ P 〉 0.05 ）. Conclusion Losartan can effectively reduce blood pressure. At the same time, it improves RBC deformation capability, reduce erythrocyte aggregation, Fib, Hct of essential hy- pertensive patients, and reduce blood viscosity. Losartan can also reduce myocardial hypertrophy, heart weight, and improve heart function.

关 键 词：原发性高血压 氯沙坦 血流动力学 超声心动图 血栓前状态 

分 类 号：R544.1[医药卫生—心血管疾病]