坎地沙坦治疗中青年高血压及靶器官保护作用研究

目的：观察坎地沙坦治疗中青年高血压患者的疗效，并探讨其对靶器官的保护作用。方法将162例中青年高血压患者随机分为两组，对照组80例患者予以卡托普利片25 mg口服，每日二次，治疗疗程为6个月。治疗组82例患者予以坎地沙坦片8 mg口服，每日一次，治疗疗程为6个月。对比观察两组患者治疗前后血压控制有效率，和左心室重量指数（LVMI）、左心室舒张末内径（LVEDd）、左心室后壁舒张末厚度（LVPWT）、室间隔舒张末厚度（IVST）以及肱动脉内皮依赖性舒张功能（FMD）。结果治疗6个月后，治疗组的降压有效率（90.24％）高于对照组（75.32％），差异有统计学意义（χ2=6.27，P＜0.05）。两组患者在治疗6个月后LVMI、LVEDd、IVST和LVPWT均见明显改善，差异均有统计学意义（t分别=6.13、2.67、3.15、6.75；5.37、9.83、9.13、10.23，P均＜0.05），其中在LVEDd方面，治疗组优于对照组，差异有统计学意义（t=6.13，P＜0.05）；两组患者治疗后FMD均有提高，两组组内治疗前后的差异有统计学意义（t分别=2.45、3.56，P均＜0.05），且治疗组治疗后的FMD明显低于对照组，差异有统计学意义（t=3.36，P＜0.05）。结论坎地沙坦治疗中青年高血压，其降压效果优于卡托普利，且能更有效改善血管内皮功能及逆转左心室肥厚。

Research of candesartan on treating young and middle-aged patients with hypertension and protecting target or-gan

Objective To observe the curative effect of candesartan on treating hypertension of young and middle-aged and explore its protective effect on target organ. Methods A total of 162 cases of hypertension were randomly divided into two groups with 80 patients in each. The control group was given captopril tablets 25 mg, orally, twice a day. The treat-ment group was given candesartan tablets 8 mg, orally, once a day. The treatment courses of two groups were 6 months. the blood pressure effective controlling rate, left ventricular mass index （LVMI）, left ventricular diastolic diameter （LVEDd）, left ventricular posterior wall end diastolic thickness （LVPWT）, ventricular septal end diastolic thickness （IVST） and brachial artery endothelial dependent diastolic function （FMD） before and after treatment were observed and compared. Results After six months treatment, the blood pressure effective controlling rate of the treatment group was significantly higher than that of control group （χ2=6.27, P〈0.05）. And compared to prior treatment, the LVMI, LVEDd, IVST and LVPWT levels of two groups at posttreatment were significantly lower （t=6.13, 2.67, 3.15, 6.75; 5.37, 9.83, 9.13, 10.23, P〈0.05）. The LVEDd level of treatment group was better than control group, the difference was statistical significance（t=6.13, P〈0.05）. The FMD of two groups at posttreatment were all significantly improved（t=2.45, 3.56, P〈0.05） and the FMD of treatment group was significantly lower than that of the control group（t=3.36,P〈0.05）. Conclusion The depressurization effect of candesartan is better than Kato Pury in young and middle-aged patients, and can effectively improve endothelial function and left ventricular hypertrophy.