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目的:研究高血压病患者左室舒张功能不全治疗的最佳方案。方法:将60例门诊高血压病患者随机分为3组:氨氯地平组给予苯磺酸左旋氨氯地平5 mg每晚1次;依那普利组给予马来酸依那普利10 mg每日2次;联合用药组给予苯磺酸左旋氨氯地平2.5 mg每晚1次+马来酸依那普利5 mg每日2次。对比治疗前和6个月后随访时的左室射血分数(LVEF)、心电机械图S2至E峰时间(IVRT)、二尖瓣血流峰值速度E/A,并对比各组中不良反应的发生率。结果:3组内治疗前后LVEF无显著性差异;IVRT、E/A改善具有显著性。3组间治疗后结果比较LVEF、IVRT均无统计学差异,联合用药组E/A较单独用药组具有统计学差异(均P<0.05)。结论:对伴有左心室舒张功能不全的高血压病患者,氨氯地平和依那普利对舒张功能的指标均有改善;而氨氯地平和依那普利小剂量联合使用,对舒张功能的指标E/A有更显著地改善,且副作用发生率较低。
Objective: To study the best treatment of left ventricular diastolic dysfunction in hypertensive patients. Methods: Sixty patients with outpatient hypertension were randomly divided into three groups: amlodipine was given levamlodipine besylate 5 mg once night and enalapril maleate enalapril 10 mg 2 times a day; combination group was given levamlodipine besylate 2.5 mg once night + enalapril maleate 5 mg twice daily. The left ventricular ejection fraction (LVEF), electrocardiogram S2-E peak time (IVRT), mitral flow peak velocity E / A were compared before and 6 months after treatment. The incidence of reaction. Results: There was no significant difference in LVEF between the three groups before and after treatment. The improvement of IVRT and E / A was significant. There were no significant differences in LVEF and IVRT between the three groups after treatment. E / A in combination group was significantly higher than that in the other groups (all P <0.05). CONCLUSION: Amlodipine and enalapril both improve the diastolic function in hypertensive patients with left ventricular diastolic dysfunction. However, the combination of amlodipine and enalapril in combination with low dose of diazepam can improve diastolic function Of the indicators E / A is more significantly improved, and the incidence of side effects is lower.