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目的 :旨在观察螺内酯对苯那普利长期使用的降压疗效及改善左室肥厚作用的影响。方法 :136例轻、中度高血压病人先予苯那普利 10mg·d-1口服治疗 1个月 (A组 ) ,未达显效者再随机分为B组和C组 ,单盲法分别加服氯沙坦 5 0mg·d-1和螺内酯 4 0mg·d-1,治疗一个月。 3组中显效病人 (A组 5 7例 ,B组 2 0例 ,C组 2 1例 )均继续原方案治疗 12个月。治疗前及治疗后 6 ,12个月末观察 :(1)诊室血压 ;(2 )超声心动测左室舒张末内径、左室后壁厚度、室间隔厚度、EF值及A/E比值 ,并计算左室重量、左室重量指数 ;(3)测血钾、肾功、血糖、血脂。结果 :苯那普利小剂量单用 ,近期显效率 4 1.9% ,长期使用仍能维持降压疗效 ,但需增加剂量。未显效者加用氯沙坦和螺内酯后 ,近期显效率分别为 5 7.14 %和 6 1.76 % ,长期用药血压维持正常率分别为 91.4 3%和 94 .12 %。 3组均有显著逆转左室肥厚作用 ,治疗后LVDD、IVST、LVPWT、LVMW及LVMI及A/E均明显降低 ,EF值均有明显升高 ,P <0 .0 5或P <0 .0 1。 6个月末 3组无差异P <0 .0 5 ;12个月末B、C两组接近P >0 .0 5 ,但均优于A组 ,P <0 .0 5。治疗前后对血钾、肾功、血糖、血脂均无显著影响。结论 :螺内酯在加强苯那普利长期降压及改善左室肥厚作用方面 ,与氯沙坦一样有效。且?
Objective: To observe the effects of spironolactone on long-term use of benazepril in lowering blood pressure and improving left ventricular hypertrophy. Methods: One hundred and sixty-six patients with mild and moderate hypertension were treated with benazepril 10 mg · d-1 orally for one month (group A), and those who did not achieve effective were randomly divided into group B and group C Add losartan 50mg · d-1 and spironolactone 4 0mg · d-1, for one month. 3 patients in the effective group (A group of 57 cases, B group 20 cases, C group 21 cases) continued the original program for 12 months. Before treatment and at the end of 6 and 12 months after treatment, we observed: (1) blood pressure in the clinic; (2) left ventricular end diastolic diameter, left ventricular posterior wall thickness, interventricular septal thickness, EF value and A / E ratio were calculated by echocardiography Left ventricular mass, left ventricular mass index; (3) measuring potassium, kidney function, blood glucose, blood lipids. Results: Benazepril low-dose single, the recent significant efficiency of 4 1.9%, long-term use can still maintain antihypertensive effect, but need to increase the dose. The non-effective use of losartan and spironolactone, the recent significant rates were 5 7.14% and 6 1.76%, long-term use of blood pressure to maintain normal rates were 91.4 3% and 94.12%. The LVH, IVST, LVPWT, LVMW, LVMI and A / E in all three groups were significantly reduced, and the EF values were significantly increased, P <0.05 or P <0. 1. There was no difference between the three groups at the end of 6 months (P <0.05). At the end of 12 months, the B and C groups were close to P> 0.05, but both were better than the group A (P <0.05). Before and after treatment of serum potassium, kidney function, blood glucose, blood lipids had no significant effect. CONCLUSIONS: Spironolactone is as effective as losartan in enhancing long-term antihypertensive effects of benazepril and improving left ventricular hypertrophy. And?