坎地沙坦联合卡维地洛治疗高血压并逆转左室肥厚改善心功能的疗效观察  

Clinical evaluation of candesartan in treating hypertension and reversing left ventricular hypertrophy and improving cardiac function

作　　者：许慧健[1] 米红[2] 

机构地区：[1]北海市人民医院药剂科,广西北海536000 [2]北海市人民医院心内科

出　　处：《临床心血管病杂志》2009年第8期615-617,共3页Journal of Clinical Cardiology

摘　　要：目的:探讨对血管紧张素转化酶抑制药不能耐受患者,应用坎地沙坦联合卡维地洛治疗高血压的降压效果、安全性与逆转高血压心肌肥厚和改善心功能的疗效。方法:将119例原发性高血压并左室肥厚患者随机分为坎地沙坦+卡维地洛组(A组)和吲哒帕胺+卡维地洛组(B组),观察血压、不良反应,并作多普勒超声心动图检测。结果:①2组治疗12个月后,收缩压与舒张压均有明显下降[155/98mmHg(1mmHg=0.133kPa)至137/85mmHg;157/101mmHg至140/88mmHg,均P<0.01]。②A组治疗12个月后,左室舒张末期内径、左室后壁与舒张末期室间隔厚度较治疗前显著下降(P均<0.05),左室重量及左室重量指数下降更显著(P均<0.01);而在B组治疗12个月后左室后壁与室间隔厚度无明显变化,左室重量及左室重量指数有所下降(P<0.05)。③A组患者治疗后的心排血量、左室射血分数、舒张早期与舒张晚期峰值流速的比值、E峰减速度均不同程度得到改善,B组治疗前后差异无统计学意义。结论:原发性高血压患者经坎地沙坦加卡维地洛治疗12个月后,可使其左室肥厚显著逆转及左室功能显著改善。Objective：To study the efficacy and safety of candesartan and cavedilol in lowering hypertension, reversing left cardiac hypertrophy and improving cardiac function, in that patients with the history of intolerance to angiotensin coverting enzyme inhibitors. Method： A hundred and nineteen patients were randomized into the cande sartan and cavedilol group or Indapamide and cavedilol group,after abserved blood pressure and ADR, All patients were measured by echoeardiography. Result： （1） Twelve months after treatment with candesartan or indapamide , blood pressure was reduced from 155/98 to 137/85 mmHg （P〈0.01）or from 157/101 to 140/88 mmHg （P〈 0.01）. （2）Left ventricular hypertrophy （LVH）,left ventricular posterior wall thickness（PWT）,ventricular septal thickness （VST）were reversed and the left ventricular mass index （LVMI）was obviously reduced after treatment with candesartan. But left ventricular posterior wall thickness（PWT）,ventricular septal thickness （VST）were not changed in indapamide group. （3）Candesartan also effectively improved cardiac function, cardiac output（CO）, left ventricular ejeetio fraction（LVEF）, early diastolic peak flow velocity in the late diastolic ratio（E/A） and E peak decrease velocity（Edc）. Conclusion： Twelve months after treatment with candesartan and cavedilol resulted in a significant reduction of LVH and a significant amelioration of left ventricular diastolic function in patients with essential hypertension.

关 键 词：高血压 坎地沙坦 心室重构 心功能 

分 类 号：R544.1[医药卫生—心血管疾病] R749.3[医药卫生—内科学]