氨氯地平联合替米沙坦及复方盐酸阿米洛利治疗高血压和左室肥厚的效果及其与瘦素的关系

目的 比较氨氯地平联合应用替米沙坦（氨+替组）及氨氯地平联合应用复方盐酸阿米洛利（氨+阿组）对高血压患者血压及左室肥厚（LVH）的影响，并探讨血压和左室肥厚与血清瘦素水平的关系。方法 将确诊的92例LVH患者随机分配到氨+替组（46例）和氨+阿组（46例）。治疗半年后，观察两组患者心脏形态学、心脏功能及血清瘦素水平的变化。结果 氨+替组及氨+阿组患者经过治疗后，收缩压、舒张压、室间隔厚度、左室质量、左室质量指数及血清瘦素水平与治疗前比较，均有显著降低（均P<0.01），E/A比值及EF值与治疗前比较有显著增高（P<0.05），但两组间治疗后收缩压、舒张压差别无统计学意义，余均有显著改变（P<0.05），氨+替组作用更明显。结论 氨+替组有更好的降压、保护心脏的效果。瘦素参与了左心室肥厚的发生、发展，可作为观察高血压患者病情变化的指标。

Effects of amlodipine association telmisartan and amilorid in the treatment of high blood pressure and left ventricular hypertrophy and its relationship with leptin

AIM To compare the application of amlodipine united telmisartan and amlodipine combination amiloride on blood pressure in patients with hypertension and left ventricular hypertrophy, and explore the left ventricular hypertrophy(LVH) and the relationship between serum leptin level. METHODS 92 cases of diagnosed LVH were randomly assigned to amlodipine+amiloride group (46 cases) or amlodipine+telmisartan group (46 cases). Six months after treatment, cardiac morphology, cardiac function and serum leptin level changes were observed in patients. RESULTS Amlodipine + amiloride group and amlodipine+telmisartan group of patients after treatment, systolic blood pressure, diastolic blood pressure, ventricular septal thickness, left ventricular mass, left ventricular mass index, E/A ratio, EF values and serum leptin levels were significantly change (P<0.01 or P<0.05), but between the two groups after treatment systolic pressure, diastolic blood pressure difference was not statistically significant, more than all the differences (P<0.05). CONCLUSION The two groups were significantly lower blood pressure, reverse left ventricular hypertrophy and improve cardiac function and reduce the role of serum leptin level, but the role of amlodipine+telmisartan group even more obvious. Tips for group amlodipine+telmisartan has a better treatment of hypertension, the effectiveness of the protection of the heart and prompt leptin involved in the occurrence of left ventricular hypertrophy, development, and that leptin can be used as observation of changes in hypertensive patients with target.