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目的:比较优化联合降压治疗及标准联合降压治疗对高血压左室肥厚患者左室重量指数及血清瘦素水平的影响,并探讨左室肥厚与血清瘦素水平的关系。方法:72例高血压左室肥厚患者随机分配到优化联合降压组(n=36)或标准联合降压组(n=36)。优化降压组为:氨氯地平5mg/d+替米沙坦80mg/d。标准降压组为:氨氯地平5mg/d+复方盐酸阿米洛利1片/d。治疗6个月后,检测并比较两组患者治疗前后左室重量指数及血清瘦素水平的变化。结果:标准联合降压组及优化联合降压组患者经过6个月药物干预后,(1)平均左室重量指数分别由183.3±44.6g/m2,174.9±37.2g/m2降至154.4±34.4g/m2,138.0±33.9g/m(2均P<0.01),优化降压组降低程度更为显著(P<0.05)。(2)血清瘦素水平分别由(7.3±1.6)μg/L,(7.2±1.9)μg/L降至(4.8±1.3)μg/L,(3.4±1.3)μg/L,差异有统计学意义(P<0.01),且优化降压组降低程度更为明显(P<0.05)。结论:优化联合降压组比标准联合降压组对高血压患者左室肥厚的逆转效果及降低血清瘦素水平的作用更佳。瘦素参与了左心室肥厚的发生、发展。
OBJECTIVE: To compare the effects of combined antihypertensive therapy and standard antihypertensive therapy on left ventricular mass index and serum leptin levels in hypertensive patients with left ventricular hypertrophy and to investigate the relationship between left ventricular hypertrophy and serum leptin levels. Methods: Seventy-two hypertensive patients with left ventricular hypertrophy were randomly assigned to receive either an optimal combination of antihypertensive drugs (n = 36) or standard antihypertensive drugs (n = 36). Optimized antihypertensive group: amlodipine 5mg / d + telmisartan 80mg / d. Standard antihypertensive group: amlodipine 5mg / d + amiloride hydrochloride compound 1 / d. After 6 months of treatment, the changes of left ventricular mass index and serum leptin level before and after treatment were detected and compared between the two groups. Results: After six months of drug intervention, the mean LV mass index decreased from 183.3 ± 44.6g / m2 and 174.9 ± 37.2g / m2 to 154.4 ± 34.4 in the standard combined antihypertensive group and the optimized combined antihypertensive group, respectively g / m2 and 138.0 ± 33.9 g / m respectively (P <0.01 for both groups), and the degree of reduction in the optimized antihypertensive group was more significant (P <0.05). (2) Serum leptin level decreased from (7.3 ± 1.6) μg / L and (7.2 ± 1.9) μg / L to (4.8 ± 1.3) μg / L and (3.4 ± 1.3) μg / L, respectively (P <0.01), and the degree of reduction in the optimized antihypertensive group was more significant (P <0.05). Conclusion: The effect of reversed combined with antihypertensive group on the reversal of left ventricular hypertrophy and serum leptin level is better than that of standard combined antihypertensive group. Leptin participates in the occurrence and development of left ventricular hypertrophy.