【摘要】 目的 :应用多普勒超声指标心肌作功指数 (MPI)评价氯沙坦钾对老年原发性高血压 (EH)患者左室功能的作用。方法 :38例老年EH患者 ,按照超声心动图左室肥厚 (LVH)的诊断标准分成无LVH(2 8例 )和LVH(10例 )两组 ,给予氯沙坦钾 5 0mg每日 1次口服 ,疗程 2 4周。治疗前后多普勒超声心动图测定左室室壁厚度和收缩、舒张功能 ,根据等容舒张期时间 (IRT)和等容收缩期时间 (ICT)之和与射血时间 (ET)的比值计算MPI。结果 :LVH组患者经氯沙坦钾治疗后左室重量指数 (LVMI)降低 ,但差异无统计学意义。两组患者射血分数 (EF)治疗前后均在正常范围 ,经氯沙坦钾治疗后IRT均显著缩短 [(12 0 .4 6± 2 3.84 )ms∶(96 .4 6± 2 3.19)ms;(12 5 .4 0± 2 5 .81)ms∶(92 .5 6± 2 9.98)ms,P <0 .0 1],MPI降低 [(0 .6 1± 0 .14 )∶(0 .4 4± 0 .12 ) ,P <0 .0 1;(0 .6 0± 0 .14 )∶(0 .4 7± 0 .13) ,P <0 .0 5 ]。MPI与IRT呈正相关 (r =0 .80 ,P <0 .0 1) ,与LVMI不相关 (r =- 0 .0 95 ,P >0 .0 5 )。结论 :氯沙坦钾能提高老年EH患者的左室功能。MPI综合反映心脏的收缩和舒张功能 ,其不受左室构型的影响 ,在高血压患者收缩功能正常的情况下是反映早期左心功能不全的指标。更多还原

【Abstract】 Objective:To observe the effect of losartan K on left ventricular function in elderly patients with essential hypertension using the Doppler-derived myocardial performance index (MPI).Method:Thirty-eight elderly patients from the geriatric department with mild to moderate hypertension were divided into two groups according to the echocardiographic diagnositic criteria of left ventricular hypertrophy (non-LVH group n=28; LVH group n=10) and accepted the anti-hypertensive treatment of 50 mg losartan K by oral once a day for 24 weeks. Doppler echocardiographic data were measured before and after treatment. The MPI was calculated as follows: MPI=(IRT+ICT)/ET( IRT: isovolumic relaxation time, ICT: isovolumic contraction time, ET; ejection time).Result:There was no significant difference in Left ventricular mass index (LVMI) after treatment, although LVMI decreased in LVH group. Ejection fraction (EF) was normal and IRT, MPI decreased in two groups [( 120.46± 23.84)∶( 96.46± 23.19)ms, ( 125.40± 25.81)∶( 92.56± 29.98)ms, P< 0.01), ( 0.61± 0.14 )∶( 0.44± 0.12), P< 0.01, ( 0.60± 0.14)∶( 0.47± 0.13), P< 0.05)]. MPI was positively correlated with IRT (r= 0.80, P< 0.01). There was no relationship between LVMI and MPI(r=- 0.095, P> 0.05). Conclusion:Losartan K can improve the left ventricular function in elderly patients with essential hypertension. Doppler-derived myocardial performance index (MPI), retlecting both systolic and diastolic function, is a useful parameter and early indicator of left ventricular dysfunction in essential hypertensive patients with normal systolic function.更多还原