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目的探讨伊贝沙坦与依那普利联合用药对原发性高血压(EH)病人左室肥厚(LVH)的逆转作用。方法EH伴有LVH病人106例随机分为A组(伊贝沙坦80mg/d,36例)、B组(依那普利10mg/d,35例)和C组(伊贝沙坦150mg/d,加依那普利10mg/d,35例)。治疗3周时若血压≥160/95mmHg,则伊贝沙坦和依那普利剂量分别增加1倍。总疗程共6个月,治疗前后24h动态血压监测和彩色超声多普勒检测左室相关指标,计算左室重量指数(LVMI)。结果①三组均能显著降低LVMI(P<0.01),其中A组和B组LVMI的降低差异无显著意义(P>0.05),C组LVMI降低较A组、B组更为显著、差异有显著意义(P<0.01)。②三组治疗前24h平均收缩压、平均舒张压差异无显著意义(P>0.05),治疗后24h平均收缩压、平均舒张压均较治疗前显著降低(P<0.01),但治疗后三组间比较均无明显差异(P>0.05)。结论伊贝沙坦、依那普利均能逆转EH病人LVH,联合用药疗效更为显著,这种协同作用与降压效应无关。
Objective To investigate the reversal effect of irbesartan and enalapril on left ventricular hypertrophy (LVH) in patients with essential hypertension (EH). Methods One hundred and six patients with EH accompanied by LVH were randomly divided into three groups: A group (36 mg irbesartan 80 mg / d), B group (enalapril 10 mg / d, 35 patients) and C group (150 mg / d, enalapril 10mg / d, 35 cases). At 3 weeks of treatment, if the blood pressure was ≥160 / 95 mmHg, the doses of irbesartan and enalapril were respectively doubled. The total duration of treatment was 6 months. Before and after treatment 24h ambulatory blood pressure monitoring and color Doppler ultrasound examination of left ventricular related indicators, calculate left ventricular mass index (LVMI). Results ① The LVMI of all three groups were significantly decreased (P <0.01), but there was no significant difference between the two groups (P> 0.05). The LVMI of group C was lower than that of group A and B Significant (P <0.01). ② The average systolic blood pressure and average diastolic blood pressure had no significant difference between the three groups before treatment 24h (P> 0.05). The average systolic blood pressure and mean diastolic blood pressure at 24 h after treatment were significantly lower than those before treatment (P <0.01) There was no significant difference between the two groups (P> 0.05). Conclusion Both irbesartan and enalapril can reverse LVH in patients with EH, and the combination therapy is more effective. The synergistic effect has nothing to do with antihypertensive effect.