培哚普利、卡托普利和硝苯地平对高血压左心室肥厚及心功能影响  

Effects of Perindopril, Captopril and Nifedipine on Hypertensive Ventricular Hypertrophy and Cardiac Function in Hypertensive Patients

作　　者：李小鹰[1] 范利[1] 王新明[1] 刘涛[1] 武惠萍[1] 

机构地区：[1]解放军总医院老年心内科

出　　处：《高血压杂志》1998年第3期186-189,共4页Chinese Journal of Hypertension

摘　　要：目的观察培哚普利、卡托普利和硝苯地平对老年高血压心室肥厚（ＬＶＨ）及心功能的影响。方法将９４例老年轻、中度高血压ＬＶＨ病人随机分为培哚普利、卡托普利和硝苯地平３组。服用安慰剂２周后分别用药３个月，剂量递增，于实验前、用药前、用药后每月分别测定动脉血压，超声心动图左室舒张末内径、舒张期室间隔厚度、左室后壁厚度，并由此计算左室质量指数（ＬＶＭＩ），同时测定左室缩短分数，Ｅ／Ａ比值和射血分数。结果３组病人用药前一般情况无明显差别，用药后血压均有显著下降（Ｐ＜０．００１），组间无差异。ＬＶＭＩ培哚普利组（Ｐ＜０．０１）和卡托普利组（Ｐ＜０．００１）用药后有显著减低，Ｅ／Ａ比值明显升高（均Ｐ＜０．００１）。而硝苯地平组仅有Ｅ／Ａ比值升高（Ｐ＜０．０５）。左室缩短分数和射血分数３组均未见明显变化。结论对老年轻中度高血压ＬＶＨ病人，三药均可有效降低血压，卡托普利和培哚普利明显减轻ＬＶＨ，并改善左室舒张功能。Aim\ Comparison of efficacy of perindopril, captopril and nifedipine on left ventricular hypertrophy(LVH) and cardiac function in the elderly hypertensive patients.\ Methods\ 94 elderly patients of hypertension with LVH were divided randomizedly into 3 groups: perindopril(n=32, 2～8 mg, 1/d), captopril(n=30, 12.5～50 mg, 2/d) and nifedipine(n=32,5～20 mg, 2/d). Drugs were taken 3 months with increased dosage step by step after 2 weeks placebo.\ The blood pressure(BP), echocardiographic LV end diastolic diameter(LVDd), interventricular septal thickness(IVST), LV posterior wall thickness(PWT), ejection fraction(LVEF), LV fractional shortening(LVFS) and E/A ratio were measured at the baseline, before and each month after the drugs. Left ventricular mass(LVM) and LVM index(LVMI) was calculated at the same times.\ Results\ Patient's conditions were similar among three groups. After 3 months treatment, blood pressure were reduced significantly in all three groups(all P<0 001) with no difference among them.\ LVMI decreased in captopril(P<0 001) and perindopril(P<0 01) but not in nifedipine group.\ E/A ratio increased in captopril, perindopril(both P<0 001) and in nifedipine group(P<0 05).\ The values of LVFS and LVEF were not found any significant changes in all the three groups.\ Conclusion\ The blood pressure could be well controlled by each of three drugs.\ It seems that captopril and perindopril are better than nifedipine in the reversal of LVH and improvement of LV diastolic function in the elderly hypertensive patients.

关 键 词：老年人 高血压 心室肥厚 治疗 培哚普利 

分 类 号：R544.105[医药卫生—心血管疾病]