氨氯地平联合依那普利治疗原发性高血压的临床疗效及对患者左心室肥厚的影响

摘要目的：探讨氨氯地平联合依那普利治疗原发性高血压的临床效果，观察联合用药对左心室肥厚的影响。方法：选择本院收治的原发性高血压患者92例，随机分为观察组和对照组，各46例，对照组给予苯磺酸左旋氨氯地平5mg，1次／d，口服；观察组在对照组基础上加用马来酸依那普利10mg，2次／d，口服，疗程均为24周。观察两组治疗前后血压变化，应用超声心动图测量两组左心室厚度变化。结果：治疗后，观察组总有效率为91_3％；对照组总有效率为73．9％，观察组总有效率高于对照组（P〈0．05）。治疗前两组心率、血压比较无统计学差异（P〉0．05），治疗后两组血压均明显降低，观察组收缩压、舒张压明显低于对照组（P〈O．05）；观察组心率明显低于对照组（P〈0．01）。治疗前两组左心室舒张末期室间隔厚度（Leaventricularend—diastolicventricularseptalthickness，IVST）、左心室后壁厚度（1eftventricularposteriorwallthickness，U，PwT）和左室射血分数（Leftventricularejectionfxaction，LVEF）比较无统计学差异（P〉0．05）；治疗后观察组IVST、L、，PwT明显低于对照组，LVEF明显高于对照组（P〈0．05）。结论：氨氯地平联合依那普利治疗原发性高血压能有效扭转左心室肥厚，降压效果较单独应用氨氯地平更佳。

Clinical Efficacy of Amlodipine and Enalapril in the Treatment of Essential Hypertension and the Influence on Left Ventricular Hypertrophy

Objective： To investigate the clinical effect of amlodipine and enalapril in the treatment of essential hypertension, to observe the effect on left ventricular hypertrophy. Method： 92 cases of essential hypertension were randomly divided into observation group and control group, each with 46 cases, the control group was given Levamlodipine besylate 5mg, 1/d, oral; the observation group added enalapril maleate 10mg, 2/d, oral, both for 24 weeks. Observed the changes of blood pressure in the two groups before and after treatment, used ultrasound heartbeat graph to measure the changes in left ventricular wall thickness. Results： After treatment, the total effective rate of the observation group was 91.3%; the total effective rate of the control group was 73.9%, （P 〈 0.01）. The blood pressure had no statistical difference before treatment （P〉0.05）, after the treatment blood pressure in both groups were significantly reduced, systolic pressure, diastolic pressure in observation group was significantly lower than that in control group （P 〈 0.05）; heart rate in observation group was significantly lower than the control group （P 〈 0.01）. Before treatment, there was no significant difference of IVST, LVPWT and LVEF between two groups （P 〉 0.05）; after treatment, the observation group IVST, LVPWT were significantly lower than those in control group, LVEF was significantly higher than that of the control group （P 〈 0.05）. Conclusion： Amlodipine and enalapril in the treatment of essential hypertension can effectively reverse the left ventricular hypertrophy, antihypertensive effect of is better than amlodipine alone.