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目的探讨厄贝沙坦联合卡维地洛对原发性高血压的临床疗效及其对左心室肥厚的影响。方法 78例原发性高血压合并左心室肥厚患者,口服厄贝沙坦(150~300 mg/d)及卡维地洛(20~40 mg/d),共24周,观察厄贝沙坦联合卡维地洛对高血压的降压效果以及对左心室肥厚的逆转作用,并观察不良反应。结果与治疗前比较,78例患者经厄贝沙坦联合卡维地洛治疗后收缩压〔(130.40±13.31)vs(161.50±11.22)mm Hg,P<0.01〕、舒张压〔(83.78±7.43)vs(100.10±5.52)mm Hg,P<0.01)〕均显著下降,左室舒张末期内径、左心室后壁厚度、舒张末期室间隔厚度及左室质量指数〔(131.46±11.33)vs(155.58±14.26)g/m2〕均显著减少(P<0.05或P<0.01)。3例患者治疗早期出现轻微头晕乏力,1例伴恶心,均于治疗4周后症状消失;无低血压、血管神经性水肿等严重不良反应发生。结论厄贝沙坦联合卡维地洛治疗原发性高血压疗效显著,且能够逆转左心室肥厚。
Objective To investigate the clinical efficacy of irbesartan and carvedilol in patients with essential hypertension and its effect on left ventricular hypertrophy. Methods A total of 78 patients with essential hypertension with left ventricular hypertrophy were treated with irbesartan (150-300 mg / d) and carvedilol (20-40 mg / d) for 24 weeks. Antihypertensive effects of combined carvedilol on hypertension and reversal of left ventricular hypertrophy, and observed adverse reactions. Results Compared with before treatment, systolic blood pressure (130.40 ± 13.31) vs (161.50 ± 11.22) mm Hg, P <0.01) and diastolic blood pressure (83.78 ± 7.43 ) vs (100.10 ± 5.52) mm Hg, P <0.01). The left ventricular end diastolic dimension, left ventricular posterior wall thickness, left ventricular end diastolic thickness and left ventricular mass index 〔(131.46 ± 11.33) vs (155.58 ± 14.26) g / m2] were significantly decreased (P <0.05 or P <0.01). Three patients had mild dizziness and fatigue in the early stage of treatment, and one was accompanied by nausea. The symptoms disappeared after 4 weeks of treatment. No serious adverse reactions such as hypotension and angioneurotic edema occurred. Conclusion irbesartan combined with carvedilol treatment of essential hypertension significant effect, and can reverse left ventricular hypertrophy.