氨氯地平联合阿托伐他汀对轻、中度老年高血压患者左室舒张功能的影响

摘要

Objective To evaluate therapeutic effects of amlodipine combined with atorvastatin on left ventricular diastolic function in elderly mild to moderate hypertensive patients. Methods 46 elderly mild to moderate hypertensive patients were treated by amlodipine combined with atorvastatin for 6 months. Some cardiac morphology and function indexes were determined by the Tissue Doppler Imaging before and after treatment, such as left ventricular end diastolic dimension (LVEDD), left ventricular end systolic dimension (LVESD), interventricular septum thickness (IVST), left ventricular posterior wall diastolic thickness (LVPWT), left ventricular mass index (LVMI), the peak velocity ratio of early and late diastolic period (E/A), mitral valve E wave deceleration time (DT), left atrium volume (LAV), propagation velocity of mitral flow (Vp) and pulmonary artery systolic pressure (PASP). Results Compared with pretreatment, after the treatment, the cardiac indexes of LVMI, DT, LAV and PASP apparently declined (P<0.05), while the E/A and Vp were significantly improved (P<0.05). Conclusion Amlodipine combined with atorvastatin can inhibit ventricular remodeling and improve cardiac left ventricular diastolic function in elderly mild to moderate hypertensive patients.%目的：探讨氨氯地平联合阿托伐他汀对老年高血压患者左室舒张功能的影响。方法选择46例轻、中度老年高血压患者，在常规治疗基础上加用氨氯地平5 mg，每天1次，阿托伐他汀10 mg，每晚1次，疗程6个月。根据超声心动图结果，测定或计算患者治疗前后的下列左心室结构及舒张功能等指标参数：左室舒张末径（LVEDD）、左室收缩末径（LVESD）、室间隔舒张末期厚度（IVST）、左室后壁舒张末期厚度（LVPWT）、左室质量指数（LVMI）、二尖瓣口舒张早期/晚期最大血流速度比（E/A）、二尖瓣E峰减速时间（DT）、左心房容积（LAV），二尖瓣血流传播速度（Vp）、肺动脉收缩压（PASP）。结果治疗6个月后，左心室结构及舒张功能指标中LVMI、DT、LAV、PASP均较治疗前明显下降，E/A、Vp均较治疗前明显增加，与治疗前比较差异有统计学意义（P＜0.05）。结论氨氯地平联合阿托伐他汀能显著改善老年高血压患者的左室舒张功能，逆转左室肥厚。