左旋氨氯地平联合缬沙坦治疗老年高血压并左心室肥厚

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1、左旋氨氯地平联合缬沙坦治疗老年高血压并左心室肥厚【摘要】　　目的探讨苯磺酸左旋氨氯地平联合缬沙坦治疗老年高血压患者左心室肥厚的临床效果。方法将58例老年高血压伴左心室肥厚患者随机分为两组，治疗组30例，对照组28例。两组均给予苯磺酸左旋氨氯地平治疗，治疗组联合缬沙坦治疗，疗程6mo。治疗前及治疗6mo末采用超声心动图超声仪检测左室舒张末期内径，室间隔与左心室后壁舒张末期厚度等各项指标并进行对比分析。结果治疗6mo末两组左室后壁舒张末期厚度、室间隔厚度、左室舒张末期内径、左室收缩末期内经、左室心肌重量指数及等容舒张时间均较治疗前明显下降，左室射血分

2、数及E/A均较治疗前显著提高（P＜0.05或0.01）；两组间比较，治疗组左室后壁舒张末期厚度、心室间隔舒张末期厚度、左室舒张末期内径、左室收缩末期内经、左室心肌重量指数、左室射血分数及E/A均较对照组改善显著，差异均有显著或极显著性（P＜0.05或0.01）。结论缬沙坦和苯磺酸左旋氨氯地平均能改善左室舒张功能，逆转扩大的左心室；苯磺酸左旋氨氯地平联合缬沙坦治疗的临床效果显著优于单用左旋氨氯地平治疗，可作为治疗高血压伴左心室肥厚患者的一线用药。【关键词】高血压；左心室肥厚；缬沙坦；苯磺酸左旋氯氯地平　　　【Abstract】ObjectiveTo

3、exploretheclinicaleffectsof9BASLamlodipinecombinedwithvalsartaninsenilehypertensioncomplicatedbyleftventricularhypertrophy.Methods58senilepatientswithhypertensioncomplicatedbyleftventricularhypertrophywererandomlydividedintothetherapy(n=30)receivingBASLamlodipinecombinedwit

4、hvalsartanandthecontrolgroup(n=28)doingsingleBASLamlodipinefor6months.Leftventricularenddiastolicdimensionandthicknessofinterventricularseptumandleftventricularposteriorwallenddiastolewerecontrastedandanalyzed.ResultsAfter6monthtreatmentthicknessoftheleftventricularposterio

5、rwallenddiastole，leftventricularenddiastolicandendsystoledimensionsandleftventricularmassindexesloweredmoresignificantlyandejectionfractionofleftventricleandE/Aincreasedmoresignificantlyofbothgroupscomparedwithpretreatment（P<0.05or0.01）；abovementionedindexesimprovedmores

6、ignificantlyinthetherapythaninthecontrolgroup，differencesweresignificantorverydignificant(P<0.05or0.01).ConclusionBoththevalsartanandBASLamlodipinecanimproveleftventriculardiastolicfunctionandreverseemlargedleftventricle；BASLamlodipinecombinedwithvalsartanisbetterthansin

7、gleLamlodipineasfirstlinedruginthetreatmentofhypertensioncomplicated9byleftventricularhypertrophy.　　【Keywords】Hypertension；leftventricularhypertroph；valsartan；BASLamlodipine　　研究表明，高血压合并左室肥厚(LVH)心血管病的并发症和病死率明显增加，左室肥厚是一项重要的独立的心血管病危险因子，它与心血管事件和病死率密切相关［1］。药物逆转LVH日益受到人们重视，其中血管紧

8、张素Ⅱ受体拮抗剂(AngiotensinⅡreceptorblocker，ARB)和第三代钙拮抗剂对LVH的逆转作用是国际心血管病领域研