精神压力相关性中青年舒张期高血压患者左室肥厚的干预研究

摘要

目的 评价缬沙坦和倍他乐克联用治疗精神压力相关性中青年舒张期高血压并左室肥厚的降压效果和左室肥厚逆转作用.方法 对所选120例就诊于青岛大学附属医院的精神压力相关性中青年舒张期高血压左室肥厚患者随机分为3组:缬沙坦组、倍他乐克组、缬沙坦+倍他乐克组,每组40例.治疗6个月后,比较3组患者治疗后的总有效率、血压、心率、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室质量指数(LVMI)、Cornell指数、Sokolow指数及不良反应发生情况.结果 3组治疗后血压、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室质量指数(LVMI)、Cornell指数、Sokolow指数均明显低于治疗前(P<0.05).倍他乐克组、缬沙坦+倍他乐克组心率较治疗前降低,差异均有统计学意义(P<0.05).3组治疗后的总有效率分别为85.0%、82.5%、95.0%,差别无统计学意义(P>0.05),缬沙坦+倍他乐克组治疗后血压、IVST、LVPWT、LVMI较缬沙坦组、倍他乐克组均有所改善,差异有统计学意义(P<0.05),缬沙坦+倍他乐克组与倍他乐克组的治疗后心率、Cornell指数、Sokolow指数无明显差别(P>0.05).治疗期间3组患者均未出现严重不良反应.结论 对于精神压力相关性中青年舒张期高血压并左室肥厚患者,缬沙坦和倍他乐克均可有效降压,逆转左心室肥厚,而缬沙坦和倍他乐克联用能更好降压并逆转左心室肥厚.%Objective To review the antihypertension effect and reverse effect of valsartan and metoprolol on diastolic hypertension related to mental stress and left ventricular hypertrophy (LVH) in young and middle-aged patients.Methods The patients (n=120) chosen from the Affiliated Hospital of Qingdao University were randomly divided into valsartan group, metoprolol group and valsartan+metoprolol group (eachn=40). After treatment for 6 months, the indexes of the total effective rate, blood pressure (BP), heart rate (HR), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular mass index (LVMI), Cornell index and Sokolow index, and adverse reactions were compared in 3 groups.Results The levels of BP, IVST, LVPWT, LVMI, Cornell index and Sokolow index were significantly lower in 3 groups after treatment (P<0.05). HR decreased in metoprolol group and valsartan+metoprolol group after treatment (P<0.05). The total effective rate was, respectively, 85.0%, 82.5% and 95.0% in 3 groups (P>0.05). BP, IVST, LVPWT, and LVMI were all improved in valsartan+metoprolol group compared with valsartan group or metoprolol group after treatment (P<0.05). HR, Cornell index and Sokolow index had no significant difference between valsartan+metoprolol group and metoprolol group (P>0.05). There were no severe adverse reactions in 3 groups during treatment period.Conclusion Valsartan and metoprolol all can effectively reduce BP and reverse LVH, and valsartan combining with metoprolol is more effective in young and middle-aged patients with diastolic hypertension related to mental stress and LVH.