CAJ | 학술논문

目的观察厄贝沙坦氢氯噻嗪片对中老年原发性高血压患者血压晨峰(MBPS)及左心室质量(LVM)相关参数的影响.方法选择120例轻中度原发性高血压患者,口服厄贝沙坦氢氯噻嗪片150 ms/12.5 mg,4～8周不达标者剂量加倍,治疗12个月,应用动态血压监测(ABPM)评价治疗前后MBPS的变化,应用超声心动图评价LVM相关参数的变化.结果 (1)经厄贝沙坦氢氯噻嗪片治疗后,MBPS(+)的患者减少,MBPS(-)的患者增多,与治疗前比较差异有统计学意义(P<0.01).(2)治疗后MBPS(+)患者晨峰程度较治疗前明显降低[收缩压(SBP)差值(16.1±1.8)mm Hg(1 mm Hg=0.133 kPa)比(29.4±2.8)mm Hg,舒张压(DBP)差值(10.2±2.3)mm Hg比(21.2±2.2)mm Hg,P<0.01],而MBPS(-)患者晨峰程度较治疗前无明显下降[SBP差值(11.2±2.4)mm Hg比(10.1±1.2)mm Hg,DBP差值(5.9±1.9)mm Hg比(6.8±3.2)mm Hg].(3)MBPS(+)和MBPS(-)患者治疗后LVM相关参数较治疗前均明显减小,且MBPS(+)患者治疗后左心室后壁厚度、LVM、LVM指数与MBPS(-)患者治疗后比较差异有统计学意义(P<0.05).结论厄贝沙坦氢氯噻嗪片能有效遏制MBPS的发生,降低晨峰程度,并能逆转左心室肥厚.
목적 관찰액패사탄경록새진편대중노년원발성고혈압환자혈압신봉(MBPS)급좌심실질량(LVM)상관삼수적영향.방법 선택120례경중도원발성고혈압환자,구복액패사탄경록새진편150 ms/12.5 mg,4～8주불체표자제량가배,치료12개월,응용동태혈압감측(ABPM)평개치료전후MBPS적변화,응용초성심동도평개LVM상관삼수적변화.결과 (1)경액패사탄경록새진편치료후,MBPS(+)적환자감소,MBPS(-)적환자증다,여치료전비교차이유통계학의의(P<0.01).(2)치료후MBPS(+)환자신봉정도교치료전명현강저[수축압(SBP)차치(16.1±1.8)mm Hg(1 mm Hg=0.133 kPa)비(29.4±2.8)mm Hg,서장압(DBP)차치(10.2±2.3)mm Hg비(21.2±2.2)mm Hg,P<0.01],이MBPS(-)환자신봉정도교치료전무명현하강[SBP차치(11.2±2.4)mm Hg비(10.1±1.2)mm Hg,DBP차치(5.9±1.9)mm Hg비(6.8±3.2)mm Hg].(3)MBPS(+)화MBPS(-)환자치료후LVM상관삼수교치료전균명현감소,차MBPS(+)환자치료후좌심실후벽후도、LVM、LVM지수여MBPS(-)환자치료후비교차이유통계학의의(P<0.05).결론 액패사탄경록새진편능유효알제MBPS적발생,강저신봉정도,병능역전좌심실비후.
Objective To investigate the influence of combined irbesartan/hydrochlomthiazide on morning blood pressure surge(MBPS)and left ventricular mass(LVM) in essential hypertension.Methods After 4-8 weeks' run-in period,if blood pressure wagn't up to the standard,the 120 patients were given irbesartan/hydrochlorothiazide once daily from 150 mg/12.5 mg for 12 months to 300 mg/25mg for another 12 months.MBPS was conducted by arnbuhry blood pressure monitoring(ABPM)and LVM was determined by echocardiography at the end of placebo baseline and 12 months later.Results (1)After treatment the patients with MBPS(+)decreased and patients with MBPS(-) increased.(2)After treatment the extents of MBPS were reduced in MBPS(+)patients[systolic blood pressure(SBP)difference(16.1±1.8)mm Hg(1mm Hg=0.133 kPa)vs(29.4±2.8)mm Hg,diastolic blood pressure(DBP)difference(10.2±2.3)mm Hg vs(21.2±2.2)mm Hg,P<0.01]with little change in MBPS(-)patients[SBP difference(11.2±2.4)mm Hg vs(10.1±1.2)mm Hg,DBP difference(5.9±1.9)mm Hg vs(6.8±3.2)mm Hg]compared with before treatment.(3)LVM indexes of all patients were significantly reduced.Conclusion Irbesartan/hydrochlorothiazide can effectively attenuate the extent of MBPS, and has advantages on reversing left ventricular hypertrophy.