摘要
目的观察伊贝沙坦对高血压左室肥厚的逆转作用。方法80例轻、中度高血压伴左室肥厚的患者随机等分为两组:伊贝沙坦组(口服伊贝沙坦150～300mg/d,24周);依那普利组(口服依那普利10～40mg/d,24周)。测量两组患者服药前、后血压的变化。通过超声心动图测量两组患者服药前后舒张末期室间隔厚度(LVST)、舒张末期左室后壁厚度(LVPWT)、左室舒张末期内径(LVDd)、左心室质量指数(LVMI)。检测两组患者服药前、后血清Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、血管紧张素Ⅱ(AngⅡ)变化。结果伊贝沙坦组在治疗后较治疗前:①血压明显降低[(128.3±8.6)mmHg比(158.9±11.2)mmHg,P<0.01],与依那普利组相似(P>0.05)。②心脏彩超指标LVDd有所降低(46.6±3.9比48.9±4.1,P<0.05),LVST、LVPWT、LVMI明显降低(分别为10.8±1.1比13.2±1.3,P<0.01,10.2±0.8比11.9±0.9,P<0.01,118.5±20.1比144.8±16.2,P<0.01),与依那普利组相似(P>0.05)。③血清学指标PCⅢ、HA明显降低(分别为103.2±14.6比135.1±17.3,P<0.01,46.7±6.9比77.6±9.4,P<<0.01)。伊贝沙坦组治疗后AngⅡ无明显变化(114.5±20.2比109.8±19.6,P>0.05),依那普利组AngⅡ较治疗前显著降低(56.4±13.5比111.5±20.4,P<0.01)。④用药过程中,伊贝沙坦组1例出现面部丘疹退出试验,其余未出现明显不良反应。依那普利组7例出现干咳,其中4例较剧烈不能耐受退出试验。结论①伊贝沙坦可有效地控制血压及逆转左室肥厚,其疗效与依那普利相似。②伊贝沙坦因无明显干咳的不良反应在临床治疗中比依那普利具有更好的耐受性和依从性。
Objective To observe the effect of Irbesartan on left ventricular hypertrophy. Methods 80 patients of essential hypertension with left ventricular hypertrophy were randomly and equally divided into two groups.Irbesartan group （treated by Irbesartan 150-300 mg/d for 24 weeks）and Enalapril group （treated by Enalapril 150-300 mg/d for 24 weeks）. Blood pressure, left ventricle diastolic dimension（LVDd）, interventricular spetum thickness （LVST）, left ventricle mass index （LVMI）, left ventricle posterior wall thickness （LWPVT）, procollagen typeⅢ （PCⅢ）, hyaluronic acid （HA） and angiotensin Ⅱ （Ang Ⅱ ） were measured before and after the treatment, Results After the treatment to Irbesartan group ： （ 1 ）the level of blood pressure were significantly decreased（ 128.3±8.6 vs 158.9±11.2,P〈0.01 ）,similar to Enalapril group（P〉0.05）. （2）LVDd decreased（46.6±3.9 vs 48.9±4.1 ,P〈0.05 ）, LVST, LVPWT, LVMI decreased significantly （LVST 10.8±1.1 vs 13.2±1.3 ,P〈0.01, LvPWT 10.2±0.8 vs 11.9±0.9,P〈0.01,LVMI 118.5±20.1 vs 144.8±16.2,P〈0.01）,（3）the level of PC Ⅲ and HA decreased significantly （PC Ⅲ 103.2±14.6 vs 135.1±17.3,P〈0,01,HA 46.7±6.9 vs 77.6±9.4,P〈0.01）, the level of Ang Ⅱ of Enalapril group decreased significantly（ 56.4±13.5 vs 111.5±20.4,P〈0.01 ） compared to Irbesartan group （114.5±20.2 vs 109.8±19.6,P〉0,05）. （4）One patient quited the treatment in Irbesartan group because of tetter.ln Enalapril group 7 patients were suffered with cough and 4 of them quited the treatment. Conclusion （ 1 ）Irbesartan has the same effect as Enalapril in lowering hypertension and reversing left ventricular hypertrophy.（2）Irbesartan has less adverse effect than Enalapril.
出处
《中国心血管病研究》
CAS
2007年第11期818-821,共4页
Chinese Journal of Cardiovascular Research
关键词
高血压
肥大
左心室
伊贝沙坦
依那普利
Hypertension
Hypertrophy,left ventricular
Lrbesartan
Enalapril
