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目的比较缬沙坦联合苯磺酸左旋氨氯地平或拉西地平对高血压伴左心室肥厚(LVH)患者超声心动图参数影响的差异。方法选择2014年1月至2016年12月收治的高血压伴LVH患者232例,根据治疗方案分为两组,一组患者服用缬沙坦(80~160 mg/d)+拉西地平片(4~8 mg/d,拉西地平组,n=112),另一组患者服用缬沙坦(80~160mg/d)+苯磺酸左旋氨氯地平片(2.5~5.0mg/d,氨氯地平组,n=120),疗程6个月。观察和比较两组患者治疗前后超声心动图参数的变化与差异。结果两组患者基线临床资料比较,性别比例、平均年龄、静息心率、体质量指数(BMI)、高血压病程、吸烟比例、血压、血脂和空腹血糖的差异无统计学意义(P>0.05)。治疗后两组患者血压下降,与本组治疗前比较差异有统计学意义(均P<0.05),氨氯地平组治疗后的血压与拉西地平组比较,差异无统计学意义(P>0.05)。两组患者的尿酸下降无统计学意义(P>0.05)。两种治疗方案能降低患者的左心室质量指数(LVMI)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、等容舒张时间(IVRT)和左心房容积指数(LAVI),增加E/A,与拉西地平组比较,氨氯地平组改善更为显著(均P<0.05);两组患者左心室射血分数(LVEF)的变化无统计学意义(均P>0.05)。结论与缬沙坦+拉西地平的治疗方案相比,缬沙坦+苯磺酸左旋氨氯地平的治疗方案能更大程度地改善高血压伴LVH患者的超声心动图参数。
Objective To compare the differences of echocardiographic parameters between valsartan and levamlodipine besylate or lacidipine in hypertensive patients with left ventricular hypertrophy (LVH). Methods A total of 232 hypertensive patients with LVH admitted to our hospital from January 2014 to December 2016 were divided into two groups according to the treatment regimen: one group received valsartan (80-160 mg / d) plus lacidipine The patients in the other groups received valsartan (80-160 mg / d), levamlodipine besylate (2.5-5.0 mg / d, ammonia in the range of 4-8 mg / d, lacidipine, n = 112) Chlorpheniramine group, n = 120) for 6 months. The changes and differences of echocardiographic parameters before and after treatment were observed and compared between two groups. Results There was no significant difference in baseline data, sex ratio, mean age, resting heart rate, body mass index (BMI), duration of hypertension, smoking percentage, blood pressure, blood lipids and fasting blood glucose between the two groups (P> 0.05) . After treatment, blood pressure decreased in both groups, with statistical significance (P <0.05), there was no significant difference between the two groups (P> 0.05) ). Uric acid drop was not statistically significant in both groups (P> 0.05). Both treatment regimens reduced LVMI, IVST, LVPWT, IVRT and LAVI and increased E / A, compared with the lacidipine group, the amlodipine group improved more significantly (all P <0.05). There was no significant difference in the left ventricular ejection fraction (LVEF) between the two groups (all P> 0.05). Conclusion Compared with valsartan + raxiridipine, the regimen of valsartan + levamlodipine besylate can greatly improve the echocardiographic parameters in hypertensive patients with LVH.