苯那普利及缬沙坦联合治疗对原发性高血压左室肥厚的逆转作用  

Effect of benazapril combined with valsartan on reversing left ventricular hypertrophy in patients with essential hypertension

作　　者：张苏川[1] 仇克难[1] 何彭孙[1] 汪湛[1] 徐福禄[1] 刘敏[1] 徐亚宁[1] 

机构地区：[1]江汉大学附属医院武汉市第六医院心内科,武汉430015

出　　处：《临床心血管病杂志》2003年第7期396-398,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨苯那普利、缬沙坦及两者联合用药对原发性高血压 (EH)患者左室肥厚 (LVH)的干预作用。方法 :EH伴有LVH患者 10 1例随机分成A组 (苯那普利 10mg/d ,36例 )、B组 (缬沙坦 80mg/d ,34例 )和C组 (苯那普利 10mg/d加缬沙坦 80mg/d ,31例 )。治疗 4周时若血压≥ 16 0 / 10 0mmHg(1mmHg =0 .133kPa) ,则苯那普利和缬沙坦剂量分别增加至 2 0mg/d和 16 0mg/d。总疗程共 2 6周 ,治疗前后用彩色超声多普勒检测左室相关数据 ,计算左室重量指数 (LVMI) ,并行 2 4h动态血压监测。结果 :① 3组治疗前后比较均能显著降低LV MI(P <0 .0 1)。其中A组和B组LVMI的降低差异无显著性意义 (P >0 .0 5 ) ,但C组LVMI降低较A组、B组两组更为显著 ,差异具有显著性意义 (P <0 .0 1)。②分别比较 3组治疗前 2 4h平均收缩压、2 4h平均舒张压差异无显著性意义 (P >0 .0 5 ) ,治疗后 2 4h平均收缩压、2 4h平均舒张压均分别较治疗前显著降低 (P <0 .0 1) ,但治疗后 3组间比较均无明显差别 (P >0 .0 5 )。结论 :苯那普利、缬沙坦均能逆转EH患者LVH ,苯那普利和缬沙坦联合用药能使这一作用更为显著 ,且这种协同作用与降压效应无关。Objective:To examine the effects of benazapril and valsartan used individually or in combination on reversing left ventricular hypertrophy (LVH) in patients with essential hypertension (EH). Methods:One hundred and one patients with EH were divided randomly into three groups: benazapril (10 mg qd, n=36), valsartan (80 mg qd, n=34) and combined treatment (benazapril 10 mg qd+valsartan 80 mg qd, n=31). If BP≥160/100 mm Hg was remained after 4 weeks treatment, then the dose double. Treatment lasted for 26 weeks. LVMI was measured by heart Doppler ultrasound before and after treatment.The blood pressure was recorded by ABPM at same time. Results:①After 26 weeks, LVMI was significantly less than before treatment in all the three groups (all P< 0.01 ). LVMI in the combined treatment group was less than that in the benazapril and valsartan groups (all P< 0.01 ). No significant difference was found between benazapril and valsartan groups (all P> 0.05 ). ②Before treatment, 24 h SBP and 24 h DBP were no significantly difference respective in all three groups (all P> 0.05 ). After 26 weeks,24 h SBP and 24 h DBP were significantly less than that before treatment in all three groups (all P< 0.01 ). After treatment, 24 h SBP and 24 h DBP were no significantly difference respective in all three groups (all P> 0.05 ). Conclusion:Benazapril combined with valsartan has additive effect on reversing LVH in patients with EH ,and this additive effect is not relate with decreasing blood pressure.

关 键 词：高血压 左心室肥厚 苯那普利 缬沙坦 

分 类 号：R544.1[医药卫生—心血管疾病] R972[医药卫生—内科学]