摘要
目的:探究培哚普利联合氨氯地平对原发性高血压伴左心室肥厚的逆转作用及对血浆N末端B型利钠肽原(NT-ProBNP)水平的影响.方法:选择原发性高血压伴左心室肥厚患者138例为研究对象,按随机数表法分为三组,均46例.对照组1予以氨氯地平治疗,对照组2予以培哚普利治疗,观察组采用培哚普利联合氨氯地平治疗.比较临床疗效、治疗前后血压情况、舒张末期左室内径(LVDd)、室间隔厚度(I与T)、左室后壁厚度(PWT)、左室重量指数(LVMI)及NT-ProBNP、同型半胱氨酸(Hcy)心钠肽(ANP)水平.结果:观察组总有效率为95.65%(44/46)高于对照组1[80.43%(37/46)]和对照组2[76.09%(35/46)](均P<0.05),对照组1和对照组2比较无统计学差异(P>0.05).治疗前,三组收缩压、舒张压、I与T、PWT、LVMI及血清NT-ProBNP、Hey、ANP水平比较,差异无统计学意义(均P>0.05),治疗后,观察组收缩压(127.87±13.66与136.46±15.73与135.00±15.98)、舒张压(81.07±5.58 与 83.98±7.16 与 85.57±7.22)、LVDd(46.48±2.24 与 48.37±3.62 与 48.30±3.57)、I 与 T(10.00±1.38 与 11.20±1.50 与 11.24±1.55)、PWT(10.52±1.35 与 12.24±1.40 与 12.37±1.39)、LVMI(124.57±10.80 与 145.13±10.27 与 144.93±10.34)、NT-ProBNP(64.53±15.63 与 75.23±18.46 与 78.15±18.54)、Hcy(8.93±2.68 与 15.48±4.66 与 14.88±4.62)、ANP(139.95±38.64 与 216.84±59.15 与 213.87±59.23)水平均较对照组1和对照组2下降(均P<0.05),对照组1和对照组2比较无统计学差异(P>0.05).结论:培哚普利联合氨氯地平对原发性高血压伴左心室肥厚治疗效果较好,可有效降低血压、改善左室相关指标,并降低 NT-Pro BNP 水平.
Abstract
Objective:To investigate the effect of perindopril combined with amlodipine on the reversal of essen-tial hypertension with left ventricular hypertrophy and the plasma N-terminal B-type natriuretic peptide(NT-Pro BNP)level.Methods:A total of 138 patients with essential hypertension and left ventricular hypertrophy were selected as the study subjects and divided into three groups(46 cases)according to random number table method.Control group 1 was treated with amlodipine,control group 2 was treated with perindopril,observation group was treated with perindopril combined with amlodipine.The clinical efficacy,blood pressure before and after treatment,end-diastolic left ventricular diameter(LVDd),ventricular septal thickness(IvsT),left ventricular posterior wall thickness(PWT),left ventricular mass index(LVMI),NT-ProBNP,homocysteine(Hey)cardiac natriuretic peptide(ANP)levels were compared.Result:The total effective rate of the observation group was 95.65%(44/46)higher than that of the control group1[80.43%(37/46)]and control group 2[76.09%(35/46)](all P<0.05),there was no significant difference between control group 1 and control group 2(P>0.05).Before treatment,there were no significant differences in systolic blood pressure,diastolic blood pressure,I vs T,PWT,LVMI and serum NT-ProBNP,Hcy and ANP levels between the three groups(all P>0.05).After treatment,systolic blood pressure(127.87±13.66 vs 136.46±15.73 vs 135.00±15.98),diastolic blood pressure(81.07±5.58 vs 83.98±7.16 vs 85.57±7.22),LVDd(46.48±2.24 vs 48.37±3.62 vs 48.30±3.57),I vs T(10.00±1.38 vs 11.20±1.50 vs 11.24±1.55),PWT(10.52±1.35 vs 12.24±1.40 vs 12.37±1.39),LVMI(124.57±10.80 vs 145.13±10.27 vs 144.93±10.34),NT-ProBNP(64.53±15.63 vs 75.23±18.46 vs 78.15±18.54),Hcy(8.93±2.68 vs 15.48±4.66 vs 14.88±4.62)and ANP(139.95±38.64 vs 216.84±59.15 vs 213.87±59.23)were lower than those of control group 1 and control group 2(P<0.05),there was no significant difference between control group 1 and control group 2(P>0.05).Conclusion:Perindopril combined with amlodipine is effective in the treatment of essential hypertension with left ventricular hy-pertrophy,which can effectively reduce blood pressure,improve left ventricular related indexes,and reduce NT-Pro BNP level.