摘要
目的 :探讨伊贝沙坦对老年原发性高血压患者的血压昼夜节律及左心室肥厚 (LVH)的影响。 方法 :选择 93例年龄≥ 60岁的老年原发性高血压患者 ,通过 2 4小时动态血压监测了解其血压昼夜节律变化 ,通过超声心动图观察左心室内径、室间隔和左心室后壁厚度 ,并测算左心室重量指数。选择血压昼夜节律消失的 5 4例患者随机分为伊贝沙坦治疗组 (伊贝沙坦组 ) 3 0例 ,吲达帕胺对照组 (吲达帕胺组 ) 2 4例。治疗 12周后两组患者再次接受动态血压监测和超声心动图检查 ,对比治疗前后血压昼夜节律及左心室参数的变化。 结果 :93例老年原发性高血压患者中合并左心室肥厚者 5 3例 ,其中血压昼夜节律消失者为 42例 (79 2 % ) ;40例无LVH患者中昼夜节律消失者为 12例 (3 0 0 % ) ,合并LVH者中血压昼夜节律消失者显著多于无LVH者 (P <0 0 0 5 ) ,有极显著性差异 ;5 4例血压昼夜节律消失者治疗 12周后昼夜节律恢复者伊贝沙坦组 2 2例 (2 2 /3 0 ) ,吲达帕胺组 9例 (9/2 4) ,两组比较有极显著性差异 (P <0 0 1) ;伊贝沙坦组高血压合并LVH者治疗后室间隔、左心室后壁厚度无显著性改变 ,但左心室重量指数与治疗前及吲达帕胺组比较均有下降 (P均 <0 0 5 ) ,均有显著性差异。 结论
Objective:To investigate the effect of irbesartan on circadian rhythm(CR)of blood pressure and left ventricular hypertrophy(LVH)*'in gerontal hypertensive patients and to observe the relation between CR and LVH. Methods:Essential hypertensive patients,aged 60 years or older(n=93),underwent ambulatory blood pressure monitoring(ABPM)and ultrasonic cardiography(UCG).The CR changes of blood pressure and the left ventricular construction including the thickness of interventricular septum and posterior wall were assessed.The patients with missed CR(n=54)were randomly given irbesartan(n=30)75 to 150 mg or indapamide(n=24)*'2 5 mg to 5 mg once a day.After 12 weeks of treatment the patients underwent ABPM and UCG again.CR and the parameters of the left ventricle after treatment were compared with those before treatment. Results:CR was missing in about 79 2%(42/53)of the patients with LVH.However,almost 70 per cent of patients presented with CR in those without LVH.Twenty two patients(73 3%)in irbesartan group(p<0 01)and 9(9/24) in indapamide group recovered CR after 12 weeks of treatment.The patients with LVH in irbesartan group had no significant change in the measurement of left ventricle compared with those before treatment (p<0.05)and the controls(p<0.01). Conclusion:The missed CR of blood pressure may be associated with the occurrence of LVH in gerontal hypertensive patients.Irbesartan treatment can effectively recover CR and delay or even depress the development of LVH.
出处
《中国循环杂志》
CSCD
北大核心
2002年第5期340-342,共3页
Chinese Circulation Journal
关键词
伊贝沙坦
老年
原发性高血压
昼夜节律
左心室肥厚
Hypertension
Irbesartan
Gerontal
Circadian rhythm
Left ventricular hypertrophy
