摘要
目的 评价应用氯沙坦 12周治疗原发性高血压患者心脏结构和血管内皮功能改变的相互关系。方法 入选 46例高血压患者 ,其中 ,男 2 0例 ,女 2 6例 ,平均年龄52 2 9± 10 2 7岁。氯沙坦治疗 4～ 6周前后根据所达目标血压 (舒张压 <90mmHg ,调整降压药 ,未达标者加寿比山 2 5mg ,观察氯沙坦治疗前后血浆内皮素的变化及应用二维和多普勒超声检测心脏结构和肱动脉血管内皮功能。结果 收缩压、舒张压、血浆内皮素、左心室重量指数在治疗 12周后明显降低 (P <0 0 1) ,反应性充血引起肱动脉内径的增加在治疗 12周后显著增加 (P <O 0 0 1) ,肱动脉内径基础值和含服硝酸甘油前后肱动脉内径变化、反应性充血后肱动脉血流量增长百分率 ,均无显著性差异 (P >0 0 5)。左心室重量指数的变化与反应性充血后肱动脉内径的变化无相关性 (β =-0 14 82 ,P >0 0 5) ,与收缩压变化 (β =0 443 ,P <0 0 0 1)、内皮素变化 (β =0 3 8,P <0 0 1)有显著相关性。 结论 氯沙坦对心血管系统的影响不仅与血压降低有关 ,同时与逆转左室肥厚、改善血管内皮功能有关。
Objectives To investigate the relationship of the effects of antihypertensive management with losartan for 12 weeks on left ventricular mass and endothelial function. Methods Forty six patients with hypertension were treated with losartan (50 mg, 50 mg+indapamide 2 5 mg/daily, according to the levels of blood pressure) for 12 weeks. All patients underwent following examinations: echocardiography, ultrasonographic examination of endothelium dependent flow mediated vascular dilation, serum endothelin before and after the treatment. Results After 12 week treatment, losartan could significantly reduce systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse blood pressure, serum endothelin concentration and left ventricular mass index ( P <0 01). There was significant difference in responsive congestion to brachial artery before and after treatment of losartan ( P <0 001). There was no significant difference in baseline and response to nitroglyerin and the increasing of reactive hypertemia flow ( P >0 05). Multiple regression analysis showed that there was no significant correlation between the change of LVMI and FMD (β=-0 1482, P >0 05). The change of LVMI was positively correlated with the change of systolic blood pressure (β=0 443, P <0 001) and the level of serum endothelin(β=0 38, P <0 01). Conclusions Hypertension management with losartan may improve endothelium function and reverse left ventricular remodeling, and it may be the cause that losartan improve the prognosis of hypertensive patients with or without left ventricular hypertrophy.
出处
《岭南心血管病杂志》
2003年第4期256-259,共4页
South China Journal of Cardiovascular Diseases
基金
广东省卫生厅科研基金项目(编号:A199990 53)
