厄贝沙坦氢氯噻嗪对高血压患者血压变异性和左心室肥厚的影响

摘要

目的 观察厄贝沙坦氢氯噻嗪对原发性高血压患者血压变异性和左心室肥厚的影响.方法 选择2009年12月至2011年12月空军航空医学研究所附属医院门诊及住院治疗的92例原发性高血压患者,口服厄贝沙坦氢氯噻嗪(每片含厄贝沙坦150 mg及氢氯噻嗪12.5 mg),1片/次,1次/d,共 8周,比较治疗前后血压、血压变异性,以收缩压、舒张压标准差(SD)表示血压变异性,24 h 收缩压、24 h 舒张压变异(24 h 收缩压变异、24 h 舒张压变异)及左心室质量的变化.结果治疗前、后24 h 收缩压变异分别为(14.8±3.6)、(9.7±2.8) mmHg(1 mmHg=0.133 kPa),24 h 舒张压变异分别为(12.9±3.1)、(8.6±2.4)mmHg,治疗后24 h收缩压变异、24 h 舒张压变异较治疗前降低,差异有统计学意义(P<0.05);治疗前左心室质量为(242±40)g,治疗后为(223±20)g,左心室质量较治疗前下降,差异有统计学意义(P<0.05).结论 厄贝沙坦氢氯噻嗪在稳定降压的同时可降低血压变异性,改善心室重构.%Objective To observe the effect of irbesartan hydrochlorothiazide tablet on variability of blood pressure and left ventricular hypertrophy in the patients with light and midrange hypertension. Methods Before the therapeutic course with irbesartan hydrochlorothiazide tablet, oral drugs were stopped in all 92 patients with hypertension for two weeks. Variability of blood pressure and left ventricular mass(LVM) with dynamic 24- hour blood pressure and echocardiography were observed in these patients before and therapeutic course. Results After treatment with oral administration of irbesartan hydrochlorothiazide tablet for 8 weeks, 24 h average systolic blood pressure (SPB) [(151±11)mmHg(1 mmHg=0.133 kPa)vs (126±10)mmHg] and 24 h SPB variability[(14.8±3.6)mmHg vs (9.7±2.8) mmHg], 24 h average diastolic blood pressure (DBP) [(96±8)mmHg vs (74±7)mmHg]and 24 h DBP variation[(12.9±3.1)mmHg vs (8.6±2.4)mmHg] were significantly decreased(P<0.05), LVM[(242±40)g vs (223±20)g]was also significantly decreased(P<0.05). Conclusion Irbesartan hydrochlorothiazide can control the blood pressure, and it can also significantly reduce the variability of blood pressure and improve ventricular reconstitute.