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目的探讨替米沙坦对伴有冠心病的原发性高血压患者左室肥厚(LVH)及超敏C-反应蛋白(hs-CRP)的影响。方法选择伴有冠心病的原发性高血压患者120例,随机分为替米沙坦组60例(A组)和贝那普利组60例(B组),分别予以替米沙坦口服(80～160mg/d)和贝那普利口服(10～20mg/d),疗程均为24周,治疗前后分别测血压、血脂、hs-CRP和超声心动图测定左室结构和功能,对比分析治疗前、后各指标的差异。结果①A、B两组治疗后收缩压和舒张压明显下降(P<0.01);②A组治疗后,甘油三酯(TG)、舒张期室间隔厚度(IVST)、舒张期左室后壁厚度(LVPWT)、左室舒张末内径(LVDd)明显降低(P<0.05);hs-CRP及左室质量指数(LVMI)显著下降(P<0.01);左室射血分数(LVEF)显著增加(P<0.01);B组治疗后TG、IVST、LVPWT、LVDd无明显的变化,但hs-CRP、LVMI下降水平及LVEF升高水平有显著差异(P<0.05);③直线相关分析显示:hs-CRP与LVMI呈正相关(P<0.05)。结论替米沙坦有效降低患者血压,显著降低hs-CRP和改善血脂代谢水平,使伴有冠心病的原发性高血压患者LVH显著逆转和心功能明显改善。
Objective To investigate the effect of telmisartan on left ventricular hypertrophy (LVH) and hypersensitive C-reactive protein (hs-CRP) in patients with essential hypertension complicated with coronary heart disease. Methods A total of 120 patients with essential hypertension complicated with coronary heart disease were randomly divided into telmisartan group 60 (group A) and benazepril group 60 (group B), and were given telmisartan orally (80 ~ 160mg / d) and oral benazepril (10 ~ 20mg / d) for 24 weeks. Before and after treatment, blood pressure, blood lipid, hs-CRP and echocardiography were used to measure left ventricular structure and function, Analyze the difference of each index before and after treatment. Results ① After treatment, the systolic and diastolic blood pressure of group A and B decreased significantly (P <0.01). After treatment, the triglyceride (TG), the thickness of interventricular septum (IVST), the thickness of left ventricular posterior wall LVPWT), left ventricular end-diastolic diameter (LVDd) decreased significantly (P <0.05), hs-CRP and left ventricular mass index (LVMI) decreased significantly <0.01). There was no significant change in TG, IVST, LVPWT and LVDd after treatment in group B, but there was significant difference between hs-CRP, LVMI and LVEF (P <0.05); ③The linear correlation analysis showed that hs- CRP and LVMI were positively correlated (P <0.05). Conclusion Telmisartan can effectively reduce the blood pressure, significantly reduce hs-CRP and improve blood lipid metabolism, so that patients with essential hypertension associated with coronary heart disease significantly reversed the LVH and cardiac function improved significantly.