缬沙坦联合氢氯噻嗪和氨氯地平治疗高血压伴左室肥厚的临床对比观察  

Clinical observation of valsartan combined with hydrochlorothiazide or amlodipine in hypertension with left ventricular hypertrophy

作　　者：梁伟健[1] 

机构地区：[1]广东省信宜市人民医院心内科,525300

出　　处：《临床合理用药杂志》2011年第21期14-16,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的通过比较缬沙坦联合氢氯噻嗪和氨氯地平治疗高血压伴左室肥厚(LVH)的临床效果,选出最优的治疗方案。方法将244例高血压伴LVH患者随机分为地平组122例和噻嗪组120例。噻嗪组给予缬沙坦80～160mg/d和氢氯噻嗪12.5～25mg/d,地平组服用缬沙坦80～160mg/d和氨氯地平2.5～10mg/d。记录患者入组时和随访2年后的室间隔舒张末期厚度(IVST)、左室舒张末期内径(LVDD)和舒张末期左室后壁厚度(LVPT),以及不良发应和随访期间发生的心血管事件。结果 2组患者治疗2年后IVST、LVDD及LVPT水平均优于入组时,差异均有统计学差异(P<0.05);但2组间比较差异无统计学意义(P>0.05)。地平组胃肠道反应和总不良反应发生率均低于噻嗪组,差异均有统计学意义(P<0.05)。地平组心力衰竭、严重心律失常及心血管事件总发生率均低于噻嗪组,差异均有统计学意义(P<0.05)。结论缬沙坦联合氢氯噻嗪和氨氯地平治疗高血压伴LVH效果相当,但联合氨氯地平更能降低心血管事件的发生率,不良反应更少,预后更好,患者获益更多。Objective To compare the effect of valsartan combined with hydrochlorothiazide or amlodipine in hypertension with left ventricular hypertrophy（LVH）. Methods 242 cases patients with hypertension with LVH were Randomly divided into amlodipine group（ n = 122 ） and hydrochlorothiazide group （n = 120）. Hydrochlorothiazide group received valsartan 80 - 160mg/d and hydroehlorothiazide 12.5 -25mg/d, and amlodipine group received valsartan 80 - 160mg/d and amlodipine 2.5 - 10mg/d. Recorded the end-diastolic interventrieular septum thickness （IVST）, left ventricular end-diastolic diameter （LVDD） , end-diastolic left ventricular posterior wall thickness （LVPWT） when the patients were chosen into the test and after two years follow-up, and recorded the adverse reaction and cardiovascular event in the tollow-up period. Results After 2 years, the level of IVST, LVDD and LVPT of two groups were better than those of before test, the difference were statistically significant（P 〈0.05 ） ;But the difference between two groups was no statistically significant（ P 〉0.05 ）. The incidence rate of gastrointestinal reaction and total adverse reaction of amlodipine group were lower than those of hydrochlorothiazide group, the difference were statistically significant（ P 〈 0.05 ）. The incidence rate of heart failure, serious arrhythmias and overall incidence of cardiovascular event of hydrochlorothiazide group were lower than those of amlodipine group, the difference were statistically significant （ P 〈 0.05 ）. Condusion The clinical effect of valsartan combined with hydrochlorothiazide or amlodipine in hypertension with left ventricular hypertrophy is similar, but the valsartan combined amlodipine can reduce the incidence rate of cardiovascular event,less adverse reaction, prognosis better, and the patients can get more benefit.

关 键 词：缬沙坦 高血压 左室肥厚 心血管事件 

分 类 号：R544.1[医药卫生—心血管疾病]