氯沙坦联合硝苯地平控释片对老年性高血压左心室构型的作用

目的:评价氯沙坦联合硝苯地平控释片对老年性高血压左心室肥厚及构型的临床作用。方法:将72例高血压患者分成两组,Ⅰ组(n=39)给予氯沙坦联合硝苯地平控释片;Ⅱ组(n=33)单用硝苯地平控释片,两组均给药12周后,行24 h动态血压监测(24 h ABPM)和超声心动图检查。结果:两组24 h ABPM参数24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 hDBP)、白昼平均收缩压(dSBP)、白昼平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)和心脏彩色超声参数舒张期室间隔厚度(IVST)、左室相对室壁厚度(RWT)、左室重量指数(LVMI)用药后均较用药前有显著下降,但I组优于Ⅱ组(P<0.05)。结论:氯沙坦联合硝苯地平控释片在逆转高血压左室肥厚方面有协同作用,且左室构型中向心性重构是防止心肌损害加重的关键阶段。

Effect of combining losartan with nifedipine controlled release tablets on left ventricular pattern in elderly essential hypertension

Objective To explore the effect of combining losartan with nifedipine controlled release tablets on hypertrophy and left ventricular pattern（LVP）in elderly essential hypertension（EH）.Method Seventy-two hypertensive patients were randomly assigned into by 2 groups.Group I（n=39）was treated with both losartan and nifedipine controlled release tablets,and group II（n=33）was treated with nifedipine controlled release tablets only.After 12 weeks,the examination of ultrasonic cardiogram was made into by 24 h ABPM and echocardiography.Results The parameters of 24 h ABPM（24 h SBP,24 h DBP,dSBP,dDBP,nSBP,nDBP） and color echocardiography（ⅣST,RWT,LVMI） after treatment in the 2 groups were significantly decreased as compared with those before treatment respectively.However,the combination group was markedly superior to nifedipine controlled release tablets group（P〈0.05）.Conclusion Losartan combining with nifedipine controlled release tablets has synergistic effect on regressing LVP in EH.To conjecture the concentric remodeling is the key stage in preventing the heart from deteriorating.