替米沙坦对高血压患者左室肥厚及C反应蛋白的影响  

Effects of Telmisartan on Levels of High Sensitivity C-Reactive Protein and Left Ventricular Hypertrophy in Patients with Essential Hypertension

作　　者：李庆辉[1,2] 杨天伦[1] 谭碧峰[3] 周环[1] 周波[1] 

机构地区：[1]湖南省中南大学湘雅医院心内科,410008 [2]湖南农业大学医院心内科,长沙市410128 [3]怀化医学高等专科学校附属怀化市第三人民医院心内科,418000

出　　处：《中华全科医学》2010年第5期554-556,共3页Chinese Journal of General Practice

摘　　要：目的探讨替米沙坦对伴有冠心病的原发性高血压患者左室肥厚(LVH)及超敏C-反应蛋白(hs-CRP)的影响。方法选择伴有冠心病的原发性高血压患者120例,随机分为替米沙坦组60例(A组)和贝那普利组60例(B组),分别予以替米沙坦口服(80～160mg/d)和贝那普利口服(10～20mg/d),疗程均为24周,治疗前后分别测血压、血脂、hs-CRP和超声心动图测定左室结构和功能,对比分析治疗前、后各指标的差异。结果①A、B两组治疗后收缩压和舒张压明显下降(P<0.01);②A组治疗后,甘油三酯(TG)、舒张期室间隔厚度(IVST)、舒张期左室后壁厚度(LVPWT)、左室舒张末内径(LVDd)明显降低(P<0.05);hs-CRP及左室质量指数(LVMI)显著下降(P<0.01);左室射血分数(LVEF)显著增加(P<0.01);B组治疗后TG、IVST、LVPWT、LVDd无明显的变化,但hs-CRP、LVMI下降水平及LVEF升高水平有显著差异(P<0.05);③直线相关分析显示:hs-CRP与LVMI呈正相关(P<0.05)。结论替米沙坦有效降低患者血压,显著降低hs-CRP和改善血脂代谢水平,使伴有冠心病的原发性高血压患者LVH显著逆转和心功能明显改善。Objective To investigate the effects of telmisartan on the levels of high sensitivity C-reactive protein（hs-CRP） and left ventricular hypertrophy（LVH） in patients with essential hypertension and coronary heart disease.Methods 120 of essential hypertension patients with coronary heart disease were randomly divided into the telmisartan group（60 cases,group A） and benazepri group（60 cases,group B）.Group A was given telmisartan（80 to 160 mg/d） and group B was given benazepril （10 to 20 mg/d）.After the treatment,all patients were followed-up for 24 weeks.Plasma sample was collected from each patient before and after treatment.Then plasma levels of cholesterol and hs-CRP were investigated.The color Doppler echocardiography was used to study left ventricular structure and function.Results （1）After 24 weeks of treatment,the blood pressure was reduced obviously（P〈0.01）.（2）After 24 weeks,Triglyceride（TG）,IVST,LVPWT,LVDd,LVMI and hs-CRP decreased significantly（P〈0.05）,but LVEF was improved obviously（P〈0.01） as compared to that before treatment in group A.Both groups showed no change in total cholesterol,HDL-C and LDL-C.（3）Linear regression analysis showed that the levels hs-CRP were positively correlated with the LVMI（P〈0.05）.Conclusion Telmisartan was effective in reducing the blood pressure,regulating the levels hs-CRP and TG,reversing LVH and improving the left ventricular function in essential hypertension patients with coronary heart disease.

关 键 词：替米沙坦 原发性高血压病 左心室肥厚 C-反应蛋白 

分 类 号：R544.1[医药卫生—心血管疾病] R542.2[医药卫生—内科学]