贝那普利与左氨氯地平联合治疗对高血压左心室肥厚患者心功能和尿微量白蛋白的影响

目的 观察贝那普利与左氨氯地平联合治疗对高血压左心室肥厚和尿微量白蛋白的疗效.方法 选择高血压并左心室肥厚及有尿微量白蛋白的患者90例,随机分为3组,分别给予贝那普利、左氨氯地平及贝那普利联合左氨氯地平治疗,于受试前、后分别测定血压及二维彩色B超,检测室间隔厚度(IVS),左心室后壁厚度(LVPW),左心室舒张末内径(LVDd),E/A,左心室射血分数(LVEF)和左心室质量指数(LVMI),同时测定尿微量白蛋白、血清尿素氮和肌酐.结果 3组在受试2周后与治疗前相比,血压均开始下降,联合治疗组降压疗效与贝那普利组、左氨氯地平组比较差异有统计学意义(P<0.05).3组治疗24周IVS、LVPW和LVMI较治疗前明显降低(均P<0.01),LVEF和E/A升高(均P<0.01).3组治疗4周后尿微量白蛋白都有所下降,其中联合治疗组明显降低(P<0.01).联合治疗组随用药时间的延长,尿微量白蛋白不断降低,24周后明显优于贝那普利组、左氨氯地平组(P<0.01).结论 贝那普利与左氨氯地平联合治疗有良好的降压作用,并且能逆转左心室肥厚,降低尿微量白蛋白及血清尿素氮和肌酐.

The clinical effect of benazepril combined with amoldipin on cardiac function and urine microalbuminuria in patients with moderate and severe primary hypertensive left ventricular hypertrophy

Objective To explore the effect of benazepril combined with amoldipin on cardiac function and urine microalbuminuria in patients with moderate and severe primary hypertensive left ventricular hypertrophy.Methods 90 patients with mild to moderate essential hypertension and left ventficular hypertrophy were randomly divided into three groups(n=30 in each group),who were treated with benazepril,amoldinpin and benazepril com-bined with amoldipin,respectively.Blood pressure was monitored and left ventricular diameter(LVDd),interven-tricular septal thick(IVS),left ventricular posterior wall(LVPW),left ventricular masses index(LVMI)were measured by echocardiography before and after treatment in three groups.Microalbuminuria,serum nitrogen and creatinine were examined at the same time.Results Both SBP and DSP were significantly decreased in three groups after two weeks treatment.E/A ratio and EF were increased at the same time(P<0.01).After treatment,these changes were more significant in Benazepril with Amlodipine group(P<0.05).After 24 week treatment IVS,LVPW and LVMI were significantly dereased(P<0.01),while LVEF and E/A increased(P<0.01).After 4-week treatment,microalbuminuria was decreased in three groups,especially in combined treatment group(P<0.01).With the time of medication in combined treatment group,microalbuminuria was increasingly decreased which was significant in benazepril and amoldipin group after 24 weeks(P<0.01).Conclusion The Benzazepril with am-lodipine are more effective in lowering blood pressure,left ventricular hypertrophy and decrease microalbuminuria.