摘要
目的 :探讨缬沙坦对 2型糖尿病伴高血压左室扩大患者心功能的影响。方法 :在胰岛素降糖基础上 ,治疗组 3 6例 ,给缬沙坦 80～ 160mg·d- 1,狄高辛 0 .12 5～ 0 .2 5mg·d- 1,氢氯噻嗪 2 5mg·d- 1或呋噻咪 2 0mg·d- 1,阿司匹林 10 0mg·d- 1;对照组 3 2例 ,将缬沙坦改为尼群地平 10～ 2 0mg ,q6h。余药同治疗组。治疗 8个月后通过双盲法 ,采用超声心动图进行对比观察。结果 :治疗组反映左室形态、收缩功能、舒张功能的指标有明显改善 (P <0 .0 5,)。对照组改善不明显。治疗组心功能改善显效率 61.1% ,有效率 3 0 .5% ,总有效率 91.6% ,对照组显效率2 5% ,有效率 18.8% ,总有效率 43 .75%。治疗组无 1例因心力衰竭死亡 ,对照组死亡 4例 (病死率 12 .5% ) ,(P <0 .0 5)。结论 :缬沙坦在胰岛素降糖基础上强心利尿加用缬沙坦可逆转扩大的左心室 ,改善收缩及舒张功能 ,降低病死率。
Objective: To investigate the effects of Valsartan on cardiac function in patients with Typ e 2 diabetes and hypertension with the left ventricular dilatation. Methods: Based on the insulin therapy, the two groups (36 patients of the therapy group and 32 patients of the control group) were given the following drugs respectively. In the therapy group, valsartan 80～160 mg·d -1 , digo xin 0.1 25 mg～ 0.25 mg·d -1 , hydrochlorothiazide 25 mg·d -1 (or furo semide 20 mg·d -1 ), Aspirin 1 00 mg·d -1 were given to the patients, while in the control group, valsar tan 80～16 0 mg·d -1 was replaced by niqundiping 10～20 mg q. 6 h. After an 8 m onth period th erapy, with a double blind method an echocardiography was used to compare som e cardiac parameters before and after the treatment of the two groups. Result: The indexes of the left ventricular remodeling (LVMI and LVID)of the left ven tricular systole function (LVESV、LVEDV、EF) and the left ventricular diastolic function((V maxE 、V maxA 、∫ E、∫ A、∫ E/∫ A)were significan tly improved in the therapy group but did not show any obvious improvement in the control group( P < 0.05 . The significantly effective rate was 61.1% and effective rate was 30.5% . T he total effective rate of the cardiac function improvement was 91.6% in the the rapy group which was higher than that of the control group. In the control grou p, the rates were 25%, 19% and 44% respectively. None died of the heart disease in the therapy group but four died in the control group, the mortality being 12. 5%. Conclusion: According to the insulin therapy, valsartan used together with digitalis and diuresis could reverse the dilated left ventricle, improve the lef t ventricular systole and diastolic functions and reduce their mortality.
出处
《药物流行病学杂志》
CAS
2003年第6期290-292,共3页
Chinese Journal of Pharmacoepidemiology
