比索洛尔干预伴左室肥厚的年轻高血压患者效果研究

发布时间：2018-04-24 16:05

本文选题：比索洛尔 + 氯沙坦　；参考：《中国新药杂志》2017年16期

【摘要】：目的:评价比索洛尔方案对伴左室肥厚的年轻高血压患者降压疗效影响,并观察其对左室肥厚的逆转作用。方法:单中心、随机、阳性药物对照、非劣效设计的开放研究。选取伴左室肥厚的年轻高血压患者64例,平均年龄(48.6±7.4)岁,随机分为比索洛尔治疗组(比索洛尔±氨氯地平)和氯沙坦对照组(氯沙坦±氨氯地平),每组32例,随访1年,测量服药前后血压、心率变化;超声心动图测量服药前后室间隔舒末厚度、左室后壁舒末厚度、E/A比值、左室射血分数(LVEF)变化,并比较两用药方案之间上述指标的差异。结果:比索洛尔组24 h平均收缩压由(138.6±12.5)降至(126.4±9.3)mm Hg,24 h平均舒张压由(89.9±10.2)降至(74.4±6.7)mm Hg,差异有统计学意义(P0.05);氯沙坦组24 h平均收缩压由(136.9±9.6)降至(124.3±6.2)mm Hg,24 h平均舒张压由(86.5±7.6)降至(74.6±7.6)mm Hg,差异有统计学意义(P0.05)。但两组间治疗前后血压差值均无统计学意义。比索洛尔组IVSTd由(12.84±1.33)降至(12.02±1.22)mm;左心室质量指数(LVMI)由(135±11.98)降至(110±10.53)g·m-2,差异有统计学意义(P0.05)。氯沙坦组IVSTd由(12.76±1.16)降至(12.07±1.02)mm;LVMI由(134±12.84)降至(112±11.08)g·m-2,差异有统计学意义(P0.01)。比索洛尔组E/A比值由(0.82±0.29)增至(1.07±0.26),差异有统计学意义(P0.05)。氯沙坦组E/A比值由(0.79±0.33)增至(0.93±0.28),差异无统计学意义。结论:对于伴左室肥厚的年轻高血压患者,比索洛尔与氯沙坦方案治疗效果相当。比索洛尔为基础的治疗方案能有效降低年轻高血压患者的血压水平,显著逆转其左室肥厚;与氯沙坦组相比,可有效改善左心室舒张功能指标E/A值。
[Abstract]:Aim: to evaluate the antihypertensive effect of Bisoprolol regimen in young hypertensive patients with left ventricular hypertrophy (LVH) and to observe its reversal effect on LVH. Methods: an open study of single center, randomized, positive drug control, non-inferior design. 64 young hypertensive patients with left ventricular hypertrophy (mean age: 48.6 卤7.4) were randomly divided into two groups: bisoprolol 卤amlodipine group and losartan control group (Losartan 卤amlodipine, 32 cases in each group). The changes of blood pressure and heart rate were measured before and after taking medicine, and the changes of ventricular septal diastolic thickness, left ventricular posterior wall diastolic thickness and left ventricular ejection fraction (LVEF) were measured by echocardiography. Results: the mean systolic blood pressure in Bisoprolol group decreased from 138.6 卤12.5 to 126.4 卤9.3)mm Hg from 89.9 卤10.2 to 74.4 卤6.7)mm Hg, the difference was statistically significant (P 0.05), and that in losartan group decreased from 136.9 卤9.6 to 124.3 卤6.2)mm Hgg from 86.5 卤7.6 to 74.6 卤7.6)mm. HG, the difference was statistically significant (P 0.05). However, there was no significant difference in blood pressure between the two groups before and after treatment. In Bisoprolol group, IVSTd decreased from 12.84 卤1.33 to 12.02 卤1.22 mm, and left ventricular mass index (LVMI) decreased from 135 卤11.98 to 110 卤10.53 g m ~ (-2). The difference was statistically significant (P 0.05). In Losartan group, IVSTd decreased from 12.76 卤1.16) to 12.07 卤1.02 卤1.02 卤12.84) to 112 卤11.08 g m ~ (-2). The difference was statistically significant (P 0.01). The ratio of E / A in Bisoprolol group increased from 0.82 卤0.29 to 1.07 卤0.26, and the difference was statistically significant (P 0.05). In losartan group, the E / A ratio increased from 0.79 卤0.33 to 0.93 卤0.28, with no significant difference. Conclusion: for young hypertensive patients with left ventricular hypertrophy, bisoprolol and losartan are effective. Bisoprolol based therapy can effectively reduce blood pressure and reverse left ventricular hypertrophy in young hypertensive patients, and improve the left ventricular diastolic function index E / A value effectively compared with losartan group.
【作者单位】：首都医科大学附属北京安贞医院高血压科;南华大学附属郴州市第一人民医院心内科;南华大学第二附属医院心血管内科;
【基金】：首都医科大学基础临床科研合作基金课题(16JL42) 首都医科大学附属北京安贞医院院长科技发展基金(2016P01) 北京市卫生与健康科技成果和适宜技术推广项目(TG-2017-32)
【分类号】：R544.1

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