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作 者:邢爱君[1] 李东贤[1] 杜鑫[1] 吴寿岭[1] 赵海燕[1] 林黎明[1] 李冬青[1] 曹正新[1] 王桂玲[1] 于青[1]
机构地区:[1]华北煤炭医学院附属开滦医院心内科,河北唐山063000
出 处:《中华高血压杂志》2008年第5期408-411,共4页Chinese Journal of Hypertension
摘 要:目的探讨氢氯噻嗪(HCTZ)与螺内酯或卡托普利长期联用对高血压病患者左室质量参数的影响。方法采用多中心随机双盲研究设计。选择9所开滦矿区医院,筛选出轻、中度高血压病患者。人选患者经安慰剂洗脱2周后随机分为螺内酯组(HCTZ 12.5 mg,1次/d+螺内酯20 mg,1次/d,n=112)和卡托普利组(HCTZ 12.5mg,1次/d+卡托普利25 mg,2次/d,n=109)。共服药36月。治疗期间每月随访1次,监测血压。洗脱期末和治疗12、24、36月末行超声心动图检查并计算左室质量指数(LVMI 或 LVMIh),采静脉血进行生化检查。结果 1)治疗12个月末,两组患者的 LVMI 均较治疗前显著下降(螺内酯组-8.9%,P<0.05;卡托普利组-12.6%,P<0.01);随治疗时间延长,两组患者的 LVMI 进一步下降(36月末与12月末比较,螺内酯组:-8.9%vs-17.5%,P<0.05;卡托普利组:-12.6%vs-19.2%,P>0.05),下降幅度组间比较无统计学意义(P>0.05);2)治疗12、24、36月末两组患者血压均显著下降(P<0.01),下降幅度组间比较,差异无统计学意义(P>0.05)。结论 HCTZ与螺内酯或卡托普利联用均能有效降低血压和 LVMI 或 LVMIh,且随治疗时间延长疗效更为显著。Objective To explore the effects of long-term treatment with HCTZ combined spironolactone or captopril on left ventricular hypertrophy in hypertensive patients. Methods A multicentres, double-blind, randomized study was carried out in 9 hospitals. After 2-weeks' washout, the eligible patients with mild-to-moderate hypertension were randomly to receive spironolactone (HCTZ 12.5 mg qd+spironolactone 20 mg qd, n=112 ) or captopril (HCTZ 12.5 mg qd+captopril 25 mg bid, n=109) for 36 months. At the end of washouting period, 12, 24, 36 months, all subjects underwent echocardiographic study. Left ventricular mass index (LVMI or LVMIh) were determined by echocardiography. Results 1 )After 12 months' treatment, both spironolactone/HCTZ and captopril/HCTZ significantly reduced LVMI ( spironolactone/HCTZ: - 8.9%, P〈0.05; captopril/HCTZ: - 12.6%, P〈0.01 ), more significant reduction of LVMI by both combined treatments were shown with the extention of treatment from 12 months to 36 months (36 months vs 12 months, spironolactone/HCTZ: -8. 9% vs -17.5%, P〈0. 05; captopril/HCTZ: - 12.6% vs - 19.2%, P〉0. 05), with no differences between two combinations groups (P〉0. 05); 2)After 12, 24, 36 months' treatment, BP was decreased significantly in each group (P〈0. 01, respectively), no siginificant intergroup differences were found (P〉0.05). Conclusion Both combined spironolactone/HCTZ and captopril/HCTZ significantly reduced BP and LVMI or LVMI and the maguitude of reduction was further enhanced after prolonged treatment.
分 类 号:R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]
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