培哚普利对高血压左室肥厚重塑影响的长期观察

目的观察血管紧张素转换酶抑制剂(ACEI)———培哚普利对高血压左室肥厚(LVH)重塑的阻抑作用。方法将83例患者分为高血压左室肥厚组41例和高血压无左室肥厚组42例,正常对照组为健康查体者40例,高血压患者每天口服培哚普利4～8mg,疗程144周(3年)。于第1周和第144周分别进行超声心动图检测左室结构和平衡法核素心室造影检测左室收缩和舒张功能。结果(1)在第1周,左室肥厚组和无左室肥厚组比较左室舒张末内径(LVEDd)、室间隔厚度(IVST)、左室后壁舒张末期厚度(LVPWT)均明显增加(P<0.05),无左室肥厚组和正常对照组比较无显著性差异;左室肥厚组和无左室肥厚组比较,左室收缩功能(LVEF、FS、PER)和舒张功能(PFR、13FF)均明显降低,无左室肥厚组和正常对照组比较无显著性差异。(2)第144周,左室肥厚组LVEDd、IVST、LVPWT和第1周比较均明显减低,3组间比较无明显差异。(3)第144周,左室肥厚组收缩功能和舒张功能与第1周比较有明显增加,3组间比较无明显差异。结论血管紧张素转换酶抑制剂培哚普利能明显减少心肌肥厚和阻抑左室重塑,随之左室收缩功能和舒张功能也得到改善。

Effect of perindopril on the left ventricular remodeling in patients with hypertensive left ventricular hypertrophy

Objective To observe the inhibition effect of angiotension converting enzyme inhibitor (ACEI)-perindopril on left ventricular remodeling (LVRM) in patients with hypertensive left ventricular hypertrophy (LVH).Methods 83 patients were divided into two groups. Group 1 (n=41)in which the patients with hypertensive LVH and group 2 (n=42) in which the patients with hypertension and without LVH. 40 healthy subjects were used as control group (group 3).The patients in group 1 and group 2 were treated with perindopril 4～8 mg a day orally for 144 weeks (3 years).At the 1st week and 144th week the left ventricular structure was measured by echocardiogram and the left ventricular systolic and diastolic function was detected by equilibrium radionuclide angiography (ERNA).Results (1)At the 1st week, LVEDd,IVST,and LVPWT in group 1 were significantly increased,as compared with those of group 2.There was no significant difference in LVEDd,IVST,and LVPWT between group 2 and group 3 ;The systolic function (LVEF,FS,PER) and diastolic function (PFR,1/3FF) in group 1 were significantly decreased, as compared with those in group 2.There was no significant difference between group 2 and group 3 in the systolic function (LVEF,FS,PER) and diastolic function (PFR,1/3FF).(2)At the 144th week,LVEDd,IVST,and LVPWT in group 1 were significantly decreased, as compared with those at the 1st week. There was no significant difference among 3 groups in LVEDd,IVST,and LVPWT.(3)At the 144th week,the systolic function (LVEF,FS,PER) and diastolic function (PFR,1/3FF) in group 1 were significantly increased, as compared with those at the 1st week .There was no significant difference among 3 groups.Conclusion Perindopril might decrease myocardial hypertrophy and inhibit LVRM, as a result, improve systolic and diastolic function of left ventricle.