A型性格对原发性高血压左心室肥厚的影响及贝那普利对其干预作用探讨

目的探讨A型性格对原发性高血压患者左心室肥厚的影响以及贝那普利对其干预的作用。方法2005年1月至2006年1月，根据A型性格量表，从本院查体中心检查的原发性高血压患者中分别筛查出A型性格（80例）和非A型性格（80例）2组，服用贝那普利3个月，剂量递增，使血压达标，并分别在治疗前后用放射免疫方法测定患者血浆血管紧张素Ⅱ（AngⅡ），超声心动图测量左室质量指数（LVMI）。结果用药前2组血压差异无统计学意义；A型性格组较非A型性格组AngⅡ、LVMI明显增高（P〈0．05）；2组的A型性格分值分别与AngⅡ、LVMI呈正相关（P〈0．05或0．01），但只有AngⅡ为独立危险因素；2组中AngⅡ和LVMI均呈正相关，并且A型性格组相关性更明显（P〈0．05或0．01）。用药后2组血压、AngⅡ及LWMI均显著下降（P〈0．05或0．01），但A型性格组AngⅡ、LVMI下降更明显（P〈0．05）；两组中AngⅡ和LVMI变化值亦呈正相关，且A型性格的相关性更明显（P〈0．05或0．01）。结论A型性格等心理因素可通过某些应激因素加重原发性高血压患者左室肥厚，贝那普利对其具有较好的干预作用。

Effect of type-A behavior pattern on intervention of benazepril in patients with essential hypertension

Objective To investigate the effects of type-A behavior pattern on intervention of benasepril in patients with essential hypertension.Methods According to the type-A behavior score patients with essential hypertension were divided into two groups:type-A group(n=80)and non-type-A group(n=80).Benazepfil was given to all patients for 3 months with gradual increase of dosage till the blood pressure (Bp)was controlled under 140/90 nlln Hg(1 mm Hg=0.133 kPa).The plasma levels of angiotensin II (Ang Ⅱ)was measured by radioimmunoassay and left yentrieular mass index(LVMI)was examined by ultrasonic echoeardiography(UCG)before and after treatmenL Results Before benazepril treatment.plasma AngⅡ levels and LVMI in type-A group were higher than those in non-type-A group(P＜0.05),but there was no difference in Bp between two groups.Type-A behavior value were positively correlated with Ang Ⅱ and LVMI in two groups,but only Ang Ⅱ level was independent risk factor.Ang II levels were positively correlated with LVMI in two groups and that was more significantly in type-A group(P＜0.05-0.01).After treatment,Bp,plasma Ang Ⅱ and LVMI were all decreased significantly in two groups(P＜0.05-0.01)and Ang Ⅱ and LVMI were decreased more markedly in type-A group(P＜0.05).The variations of Ang Ⅱ and LVMI before and after treatment were positively correlated in two groups.but more markedly in type.A group (P＜0.05-0.01).Condusion Characters may affect left ventricular hypertrophy in patients with essential hypertension through some stress factors and benazepril has better intervening effect on it.