螺内酯对高血压患者心室及血管重构的影响

目的观察螺内酯对心室及血管重构的影响。方法选取伴左心室肥厚（LVH）及颈动脉内中膜（IMT）增厚患者106例，在经两周药物洗脱期后，平分为观察组（53例）与对照组（53倒）。观察组给予硝笨地平控释片（拜新同）30mg／d，螺内酯10-20mg／d，倍他乐克12．5-25mg／d；对照组给予硝苯地平控释片（拜新同）30mg／d，氢氯噻嗪12．5-25mg／d，倍他乐克12．5-25mg／d；所有对象治疗前后均测左室舒张末内径（LVEDd）、室间隔厚度（IVST）、左室后壁舒张末期厚度（LVPWT），左心室重量指数（LVMI），射血分数（EF），颈动脉内中膜厚度（IMT），颈动脉内径，颈动脉内中膜／血管内径（IMT／R），使用EpiData（中文版）进行数据管理并行统计分析。结果两组治疗后各指标有明显差异（P〈0．05），IMT、IMT／R的变化值与LVMI呈正相关，与EF的变化值呈负相关。结论IMT、颈动脉内径、IMT／R的变化值水平可反映左室重构和左心功能。螺内酯对血管重构抑制和逆转一心室，改善心功具有显著作用。

Influece of spironolactone on ventricular and vascular remodeling in hypertension patients

Objective To observe influece of spironolactone on ventricular and vascular remodeling in hypertension patients.Methods 106 hypertension patients with left ventricular hypertrophy(LVH) and carotid artery intima(IMT) thickening were divided into observation group(53 cases) and control group(53 cases).Observation group were given nifedipine GITS(Adalat) 30mg/d,spironolactone 10-20mg/d,metoprolol 12.5-25mg/d and the control group were given nifedipine GITS(Adalat) 30mg/d,hydrochlorothiazide 12.5-25mg/d,metoprolol 12.5-25mg/d.The left ventricular end-diastolic diameter(LVEDd),interventricular septal thickness(IVST),left ventricular posterior wall diastolic thickness(LVPWT),left ventricular mass index(LVMI),ejection fraction(EF),carotid intima-media thickness(IMT),carotid diameter,carotid artery intima/vessel diameter(IMT/R) were measured with EpiData(Chinese version) for data management.Results After treatment,all indicators were significant differences(P<0.05).IMT and IMT/R were positively correlated with LVMI and negatively correlated with EF.Conclusion IMT,carotid diameter and IMT/R value level may reflect changes in left ventricular remodeling and left ventricular function.Spironolactone has a significant effect on inhibition and reversal of ventricular and vascular remodeling and improvement of cardiac function.