血管紧张素Ⅱ1型受体拮抗剂与醛固酮受体拮抗剂对逆转高血压伴左室扩大患者心肌重塑的作用

目的 :探讨缬沙坦和螺内酯对高血压伴左室扩大患者心肌重塑的影响。方法 :治疗组 6 8例 ,口服缬沙坦 80～ 16 0mg/日 ,螺内酯 2 0～ 4 0mg/日 ,地高辛( 0 .2 5mg/片 ) 0 .12 5～ 0 .2 5mg/日 ,阿斯匹林 10 0mg/日。对照组 58例 ,将缬沙坦和螺内酯改为尼群地平 10～ 2 0mg(一日三次 )和双氢克尿塞 2 5mg/日或速尿 (Lasix) 2 0mg/日外 ,余药同治疗组。治疗 6个月后采用超声技术进行对比观察。结果 :治疗组反映左室形态 ,收缩功能 ,舒张功能的指标有明显改善 (P<0 .0 5～ 0 .0 1) ;上述指标对照组改善不明显。治疗组心功能改善总有效率为95.6 % ,对照组总有效率为 4 1.4 %。结论 :缬沙坦和螺内酯在强心利尿基础上可逆转扩大的左心室 ,改善左室收缩及舒张功能。

Effects of Valsartan and Spirolactone on Cardial Function in Patients with Hypertension with Left Ventrclular Dilatation and Myocardial Remodeling

Objective:To investigate the effects of Valsartan and Spirolact one on cardial function of patients with hypertension with left ventrclular dil atation.Method:The two groups (the therapy group of 68patients and the control group of 58 patients) were given the following drugs repectively.In the therapy group ,Valsartan 80～160 mg·d -1,Spirolactone 20～40 mg·d - 1,Digoxin 0.125 mg～0.25 mg·d -1,Aspilin 100 mg·d -1,were given t o the patients,while in the control group,Valsartan 80～160 mg·d -1 was replaced by Niqundiping 10～20 mg q 6 h.Spirolactone 20～40 mg·d -1 was replaced Hydrochlorothiazide 25 mg·d -1(or Furosemide 20 mg·d -1 ).Digoxin0.125 mg～0.25 mg·d -1,Aspilin 100 mg·d -1.After 6-mon th period therapy,with double-blind method echocardiography was used to compar e some cardiac parameters before and after the both groups.Results:The indexes of left ventricular remodeling (LVMI and L V ID)of left ventricular systole function (LVESV 、LVEDV、EF)of left ventricular d iastolic function are improved in the therapy group(P<0.05,P<0.01) whil e, no such obvious improvement in the control group.The total effective rate of ca rdial function improvement is 95.6% in the therapy group,which is higher tha n that of control group,which is 41.4%.Conclusion:On the digitalis and diuresis basement therapy,I n a ddition to therapy together with Valsartan and Spirolactone could reverse the d ilated left ventricle,improve left ventricular systole function with diastolic function.