缬沙坦对高血压左室肥厚患者的左室结构、室性心律失常及心肌缺血的影响

目的：研究缬沙坦对高血压左室肥厚（LVH）患者的左室结构、室性心律失常及心肌缺血的影响。方法：86例原发性高血压左室肥厚患者随机分为2组：治疗组每天口服缬沙坦80mg,对照组第天口服非洛地平5mg。平均12个月，观察用药后血压、左室结构、室性心律失常及心肌缺血的变化。结果：用药后2组收缩压（SBP）和舒张压（DBP）均显著降低（P＜0．01）；室间隔厚度（IVST）及左室后壁厚度（LVPWT）均变薄（P＜0．01）；左室重量指数（LVMI）明显沽少（P＜0．01）；室性心律失常发生率明显降低（P＜0．01）；发作性ST段压低的发生率及持续时间明显降低（P＜0．01）；对照组各项指标无明显变化（P＜0．05）。结论：在无冠心病证据的原发性高血压左段肥厚的患者中，长期应用缬沙坦具有良好的降压效果，同时还可逆转LVH，降低室性心律失常发生率，减少心肌缺血的发生率及持续时间，改善患者的预后。

The effect of valsartan on the left ventricular structure,ventricular arrhythmia and myocardial ischemia in patients with hypertensive left ventricular hypertrophy

Objective To study the effect of valsartan on the left ventricular structure,ventricular arrhythmia and myocardial ischemia in patients with hypertensive left ventricular hypertrophy(LVH).Methods 86 cases with hypertensive LVH were randomly divided into two groups: treatment group who took orally 80 mg valsartan every day and control group who took orally 5 mg felodiping every day for average time of 12 months.After administration,blood pressure ,left ventricular structure,ventricular arrhythmia and myocardial ischmia were observed.Results After administration,systolic blood pressure(SBP) and diastolic blood pressure(DBP) in the two groups were significantly decreased(P<0.01).In treatment group,the intraventricular septum thickness(IVST) and left ventricular posterior wall thickness(LVPWT) became obviously thin(P<0.01);left ventricular mass index(LVMI) was reduced(P<0.01); the incidence of ventricular arrhythmia and myocardial ischemia were lower after treatment than before treatment(P<0.01);Myocardial ischemia last shorter after treatment than before treatment(P<0.01).However,there was no obvious changes in control group (P>0.05) .Conclusion In the patients with hypertensive LVH but without clinical history of coronary heart disease,valsartan not only has better effect of reducing blood pressure,but also can reverse LVH,reduce the incidence of ventricular arrhythmia and myocardial ischemia and improve their prognosis.