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目的观察比较缬沙坦与苯磺酸氨氯地平对原发性高血压患者左心室肥厚(LVH)的影响。方法选择医院诊治的原发性高血压患者360例,随机分为缬沙坦组和苯磺酸氨氯地平组,每组180例。缬沙坦组给予缬沙坦胶囊80~160 mg/d治疗,苯磺酸氨氯地平组给予苯磺酸氨氯地平片5~10 mg/d治疗,疗程均为12个月。比较2组治疗前、治疗后6、12个月的左室舒张末期内径(LVEDd)、室间隔舒张末期厚度(IVSd)、左室后壁舒张末期厚度(LVPWd)、二尖瓣舒张早期流速峰值(PFVE,E峰)、左房收缩期最大流速(PFVA,A峰)及E/A比值等指标,并记录患者不良反应发生情况。结果治疗24 h后,苯磺酸氨氯地平组总有效率为93.9%,高于缬沙坦组的86.1%(P<0.05)。2组患者治疗前与治疗6、12个月后LVEDd、IVSd、LVPWd、PFVE、PFVA、E/A值各参数均改善(P<0.01),且治疗12个月苯磺酸氨氯地平组较缬沙坦组各项指标改善更明显(P<0.05)。苯磺酸氨氯地平组出现头痛、消化不良2例,未经特殊处理缓解。缬沙坦组患者治疗期间未出现明显不良反应。结论苯磺酸氨氯地平长期治疗可逆转LVH、改善心脏功能且疗效显著,安全性高。
Objective To compare the effects of valsartan and amlodipine besylate on left ventricular hypertrophy (LVH) in patients with essential hypertension. Methods A total of 360 patients with primary hypertension were selected and randomly divided into valsartan and amlodipine besylate groups, 180 cases in each group. The valsartan group was treated with Valsartan 80 ~ 160 mg / d, the amlodipine besylate group was treated with amlodipine besylate 5 ~ 10 mg / d for 12 months. The left ventricular end diastolic diameter (LVEDd), interventricular septum end-diastolic thickness (IVSd), left ventricular posterior wall end-diastolic thickness (LVPWd), peak mitral early diastolic velocity (PFVE, E peak), left ventricular systolic maximum flow rate (PFVA, A peak) and E / A ratio and other indicators, and record the incidence of adverse reactions in patients. Results After treatment for 24 h, the total effective rate of amlodipine besylate group was 93.9%, which was higher than that of valsartan group (86.1%, P <0.05). The parameters of LVEDd, IVSd, LVPWd, PFVE, PFVA and E / A were improved in both groups before and 6 and 12 months after treatment (P <0.01), and the amlodipine besylate group at 12 months The indexes of valsartan group improved more obviously (P <0.05). Amlodipine besylate group headache, indigestion in 2 cases, without special treatment to ease. Valsartan group did not appear during the treatment of significant adverse reactions. Conclusion Long-term treatment with amlodipine besylate can reverse LVH and improve cardiac function with significant curative effect and high safety.