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目的评价卡维地洛加小剂量螺内酯逆转高血压左室肥厚作用。方法高血压左室肥厚病人60例分为2组(各30例),治疗组给予卡维地洛10～25mg,qd,加螺内酯20～40mg,qd;对照组给予美托洛尔12.5～25mg,bid,加氢氯噻嗪12.5mg,qd。疗程6～24mo。治疗前后采用超声心动图检查,比较2组左心室结构及功能变化,并随访6、12和24mo。结果治疗后2组血压均显著下降(P<0.01),治疗组左室后壁厚度、室间隔厚度和左室重量指数均较治疗前有显著降低(P<0.01),对照组无明显变化(P>0.05),2组间有显著差异(P<0.01)。结论卡维地洛加小剂量螺内酯有明显逆转高血压左室肥厚作用。
Objective To evaluate the effect of small dose of carvedilol plus spironolactone on hypertensive left ventricular hypertrophy. Methods Sixty patients with hypertensive left ventricular hypertrophy were divided into two groups (n = 30 each). The treatment group was given carvedilol 10-25 mg qd plus spironolactone 20-40 mg qd and the control group was treated with metoprolol 12.5-25 mg , bid, hydrochlorothiazide 12.5mg, qd. Course of 6 ~ 24mo. Before and after treatment with echocardiography, compared two groups of left ventricular structure and function changes, and follow-up 6,12 and 24mo. Results After treatment, blood pressure decreased significantly in both groups (P <0.01). LV wall thickness, interventricular septum thickness and LV mass index in treatment group were significantly lower than those before treatment (P <0.01), while there was no significant difference in control group P> 0.05), there was a significant difference between the two groups (P <0.01). Conclusion Carvedilol plus low dose spironolactone can obviously reverse the effect of hypertension on left ventricular hypertrophy.