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目的:探讨高血压患者采用氯沙坦钾片联合苯磺酸左旋氨氯地平片治疗临床疗效,并观察其对患者左心室肥厚的逆转的作用。方法:回顾性分析宁波市第七医院2013年6月-2016年6月120例原发性高血压临床治疗情况,所有患者均经超声心动图证实存在左心室肥厚及左心室舒张功能减退,其中以氯沙坦钾片100mg/d为甲组,40例;以苯磺酸左旋氨氯地平片5mg/d为乙组,40例;以50mg/d氯沙坦钾片+5mg/d苯磺酸左旋氨氯地平片治疗者为丙组,40例。两组均将血压控制在140/90mmHg以下,且不应用其他降压或影响血压药物,共治疗12周。检测三组治疗前、后血压、心率、左室结构和左室重量指数、左室功能变化;统计三组降压疗效及不良反应。结果:三组患者治疗后舒张压、收缩压较治疗前明显下降,P<0.05;然丙组治疗后血压水平明显低于甲,乙组,P<0.05,甲乙组相比,P>0.05。三组治疗前、后心率相比,P>0.05。甲组降压总有效率67.5%与乙组70.0%相比,P>0.05;然丙组降压总有效率95.0%明显高于甲乙组,P<0.05。三组治疗后LVIDd及LVIDs与治疗前相比,P>0.05;三组治疗后IVSTd和PWTd及LVMI较治疗前明显下降,且丙组下降程度优于甲乙组,P<0.05;甲乙组治疗后相比,P>0.05。三组患者治疗后LVEF及E/A明显高于治疗前,丙组治疗后心功能改善优于甲乙组,P<0.05;而甲乙组相比,P>0.05。三组不良反应较轻,且可耐受,三组不良反应率相比,P>0.05。结论:无论是单纯采用苯磺酸左旋氨氯地平片、氯沙坦钾片还是联合苯磺酸左旋氨氯地平片与氯沙坦钾片均可有利于患者心功能、血压改善,并可逆转左室肥厚,且不良反应少;但联合用药在逆转左室肥厚和降低血压等方面优于单纯用药。
Objective: To investigate the clinical efficacy of losartan potassium tablets combined with levamlodipine besylate in hypertensive patients and to observe its effect on the reversal of left ventricular hypertrophy in patients. Methods: The clinical data of 120 cases of essential hypertension in the Seventh Hospital of Ningbo City from June 2013 to June 2016 were retrospectively analyzed. All of the patients were confirmed by echocardiography to have left ventricular hypertrophy and left ventricular diastolic dysfunction. Among them, With losartan potassium tablets 100mg / d as group A, 40 cases; levamlodipine besylate tablets 5mg / d for group B, 40 cases; 50mg / d losartan potassium tablets + 5mg / d benzene sulfonamide Acid levamlodipine treatment for the group C, 40 cases. Blood pressure in both groups were controlled at 140 / 90mmHg or less, and should not be applied to other antihypertensive drugs or blood pressure, a total of 12 weeks of treatment. The blood pressure, heart rate, left ventricular structure and left ventricular mass index and left ventricular function were measured before and after treatment. The antihypertensive efficacy and adverse reactions were measured in three groups. Results: After treatment, the diastolic blood pressure and systolic blood pressure of the three groups were significantly decreased (P <0.05). The blood pressure of group C after treatment was significantly lower than that of group A and B (P <0.05, P> 0.05). Three groups before and after treatment, heart rate, P> 0.05. Group A total effective rate of 67.5% and 70.0% compared to Group B, P> 0.05; Group C total effective rate of 95.0% was significantly higher than those of Group A, P <0.05. The LVIDd and LVIDs of the three groups after treatment were significantly higher than those before treatment (P> 0.05). The IVSTd, PWTd and LVMI of the three groups were significantly lower than those before treatment, and the decline of group C was better than that of group A and group B Compared to P> 0.05. The LVEF and E / A in three groups were significantly higher than before treatment, and the improvement of cardiac function in group C was better than that in group A and B (P <0.05). Three adverse reactions were mild, and can be tolerated, three adverse reactions compared to the P> 0.05. CONCLUSION: Both L-amlodipine besylate and losartan potassium tablets combined with levamlodipine besylate and losartan potassium tablets may be beneficial for patients with cardiac function, blood pressure improvement and reversible Left ventricular hypertrophy, and adverse reactions less; but the combination of drugs in the reverse of left ventricular hypertrophy and lower blood pressure is better than simple medication.