氯沙坦对原发性高血压患者左室肥厚逆转作用

目的研究氯沙坦对原发性高血压(EH)患者的降压作用和对左室肥厚(LVH)的影响。方法选择60例EH患者,其中有LVH者22例,口服氯沙坦50 mg/d,为期6个月。观察血压,治疗前后测血脂、血糖和肝肾功能,并做二维超声心动图检测,采用自身前后对照的实验方法。结果EH患者经氯沙坦治疗前收缩压(156.9±8.9)mmHg,治疗后(138.7±1.2)mmHg。舒张压治疗前(101.3±7.5)mmHg,治疗后(85.9±6.1)mmHg,均显著下降(P<0.01)。其中LVH者左心室舒张末期内径治疗前(51.2±3.2)mm,治疗后(46.8±5.2)mm。左室重量治疗前(245.6±24.9)g,治疗后(237.1±22.4)g,均明显下降(P<0.05)。舒张末期左室后壁厚度治疗前(11.9±0.6)mm,治疗后(11.2±0.5)mm。室间隔厚度治疗前(13.4±0.8)mm,治疗后(11.7±1.5)mm。左室重量指数治疗前138.2±24.1,治疗后116.2±24.3,均明显下降(P<0.01)。结论氯沙坦治疗EH安全有效,并且可以逆转LVH。

Effect of losartan on left ventricular hypertrophy in patients with essential hypertension

Objective To study the effect of losartan on left ventricular hypertrophy in patients with essential hypertension.Methods The study population consisted of 60 essential hypertension patients,22 of them with left ventricular hypertrophy.All patients received losartan 50mg per day for half year.Left ventricular diameter and left ventricular mass index were measured by echocardiography.Results The losartan significantly decreased systolic blood pressure [from(156.9±8.9)mmHg to(138.7±1.2)mmHg],diastolic blood pressure [from(101.3 ±7.5)mmHg to (85.9±6.1)mmHg] in patients with essential hypertension(P<0.01).For the patients with left ventricular hypertrophy,losartan reduced both left ventricular end diastolic diameter [from(51.2±3.2)mm to(46.8±5.2)mm] and left ventricular mass [from(245.6±24.9)g to(237.1±22.4)g ](P<0.05).Meanwhile there were obvious improvements of diastolic left ventricular posterior wall thickness [from(11.9±0.6)mm to(11.2±0.5)mm],ventricular septum thickness[from(13.4±0.8)mm to(11.7±1.5)mm]and left ventricular mass index(from 138.2±24.1 to 116.2±24.3)(P<0.01).Conclusion Losartan is a effective drug to reverse left ventricular hypertrophy.