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目的:比较氨氯地平联合应用替米沙坦(氨+替组)及氨氯地平和替米沙坦联合应用辛伐他汀(氨+替+辛组)对高血压病患者血压及左室肥厚(LVH)的影响,探讨辛伐他汀逆转高血压病LVH的效果。方法:将确诊的79例伴有LVH的高血压病患者随机分配到氨+替组(59例)和氨+替+辛组(20例)。治疗18个月后,观察两组患者心脏形态学、心脏功能及血压水平的变化。结果:①氨+替组及氨+替+辛组高血压病患者经过治疗后,收缩压(SBP)、舒张压(DBP)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室质量(LVM)、左室质量指数(LVMI)与治疗前比较,均有显著性降低(均P<0.01)。②左室舒张早期二尖瓣血流峰速度(E)及晚期血流峰速度(A)比值(E/A)及左室射血分数(LVEF)值与治疗前比较有显著性增高(P<0.01)。③氨+替组和氨+替+辛组两组治疗后SBP、DBP差别无显著性差异,但两组间的IVST、LVPWT、LVM、LVMI的改变比较均有显著差异(P<0.05),氨+替+辛组对其降低作用的效果更明显。结论:氨+替+辛组有更强的降压、逆转LVH及改善心功能的作用,提示辛伐他汀具有逆转高血压LVH及协同保护心脏的效果。
Aims: To compare the effects of amlodipine plus telmisartan (Aminotrans) plus amlodipine and telmisartan on blood pressure and left ventricular hypertrophy in patients with essential hypertension (LVH), to investigate the effect of simvastatin on LVH in hypertensive patients. Methods: A total of 79 confirmed hypertensive patients with LVH were randomized to receive ammonia + replacement (n = 59) and ammonia plus replacement (n = 20). After 18 months of treatment, changes in cardiac morphology, cardiac function and blood pressure were observed in both groups. Results: After treatment, the patients with A + A + A + A + C + + systolic blood pressure (SBP), DBP, IVST, LVPWT, Left ventricular mass (LVM) and left ventricular mass index (LVMI) were significantly lower than those before treatment (all P <0.01). (2) The left ventricular diastolic mitral flow peak velocity (E) and late peak flow velocity (A) ratio (E / A) and left ventricular ejection fraction (LVEF) were significantly higher than those before treatment <0.01). There was no significant difference in the SBP and DBP between the two groups after treatment, but there were significant differences between the two groups in the changes of IVST, LVPWT, LVM and LVMI (P <0.05) Ammonia + for + Xin group effect of its more effective. CONCLUSION: Aminoctadine + systolic blood pressure is more effective in lowering blood pressure, reversing LVH and improving cardiac function, suggesting that simvastatin can reverse LVH and synergistically protect heart.