辛伐他汀联合氨氯地平及复方盐酸阿米洛利逆转高血压左室肥厚的效果  

Efficacy of simvastatin plus amlodipine and amiloride in the treatment of left ventricular hypertrophy of hypertension patients

作　　者：杨竞霄[1] 张志敏[1] 艾永飞[1] 

机构地区：[1]第四军医大学附属唐都医院心内科,西安710038

出　　处：《山西医科大学学报》2015年第9期845-849,共5页Journal of Shanxi Medical University

摘　　要：目的比较氨氯地平+复方盐酸阿米洛利(氨+阿)与氨氯地平+复方盐酸阿米洛利联合应用辛伐他汀(氨+阿+辛)治疗高血压伴有左室肥厚(LVH)患者的血压及左室肥厚的效果。方法将确诊的59例LVH高血压患者随机分为氨+阿组(41例)和氨+阿+辛组(18例)。治疗18月后,观察两组患者心脏形态、功能及血压水平的变化。结果氨+阿组及氨+阿+辛组患者经过治疗后,收缩压(SBP)、舒张压(DBP)、室间隔厚度(IVST)、左室后壁厚度(LVPW)、左室质量(LVM)、左室质量指数(MI)与治疗前比较,均有显著降低(P<0.01);E/A比值及EF值与治疗前比较均有显著增高(P<0.05);两组治疗后收缩压、舒张压差异无统计学意义(P>0.05),但氨+阿组与氨+阿+辛组两组治疗后的IVST、LVPWT、LVM、LVMI比较差异均有统计学意义(P<0.05),氨+阿+辛组作用更明显。结论氨+阿组具有逆转高血压左室肥厚的作用,而加用辛伐他汀后有更好的逆转LVH的作用,提示辛伐他汀具有增强氨氯地平+复方盐酸阿米洛利逆转高血压左室肥厚的作用。Objective To explore the effects of the amlodipine ＋ amiloride versus simvastatin ＋ amlodipine ＋ amiloride on hypertension and left ventricular hypertrophy（LVH） in patients with hypertension combined with LVH. Methods Fifty-nine cases of diagnosed LVH were randomly assigned into amlodipine ＋ amiloride group（ n = 41 ） and amlodipine ＋ amiloride ＋ simvastatin group （ n = 18 ）. At 18 month after treatment, the cardiac morphology, cardiac function and blood pressure changes were observed in patients. Results At 18 month after treatment, the systolic blood pressure （SBP）, diastolic blood pressure （DBP）, inter ventricular septal thickness （ IVST）, left ventricular mass （ LVM ）, left ventricular posterior wall thickness （LVPWT） and left ventricular mass index （LVMI） were significantly decreased（ P 〈 0.01 ） in amlodipine ＋ amiloride group and amlodipine ＋ amiloride ＋ simvastatin group. After treatment, E/ A ratio and EF values were significantly increased in amlodipine ＋ amiloride ＋ simvastatin group and amlodipine ＋ amiloride group（ P 〈 0.05 ）. IVST, LVPWT, LVM, LVMI were significantly lower in amlodipine ＋ amiloride ＋ simvastatin group than in amlodipine ＋ amilo- ride group after treatment（ P 〈 0.05 ）, but there was no significant difference in systolic blood pressure and diastolic blood pressure be- tween two groups （P 〉 0.05 ）. Conclusion Amlodipine ＋ amiloride ＋ simvastatin has a better effect on LVH than amlodipine ＋ amilo- ride, which suggests simvastatin can enhance the effects of amlodipine and amiloride on LVH in patients with hypertension.

关 键 词：高血压 左心室肥厚 氨氯地平 复方盐酸阿米洛利 辛伐他汀 

分 类 号：R541.3[医药卫生—心血管疾病]