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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。
Objective: To evaluate the effect of losartan potassium on left ventricular function in senile patients with essential hypertension (EH) with Doppler echocardiography myocardial work index (MPI). Methods: Thirty-eight elderly patients with EH were divided into two groups according to the diagnostic criteria of left ventricular hypertrophy (LVH) undergoing echocardiography: LVH (28 cases) and LVH (10 cases) , Treatment of 24 weeks. The left ventricular wall thickness and systolic and diastolic function were measured by Doppler echocardiography before and after treatment. According to the ratio of the sum of isovolumetric time (IRT) and isovolumetric systolic time (ICT) to ejection time (ET) MPI. Results: Left ventricular mass index (LVMI) was decreased in patients with LVH after losartan potassium treatment, but the difference was not statistically significant. The ejection fraction (EF) in both groups were in the normal range before and after treatment, and the IRT after treatment with losartan potassium was significantly shortened [(12 0. 46 ± 2 3.84) ms: (96. 46 ± 2 3.19) ms ; (12.5.4 ± 2 5 .81) ms: (92.56 ± 2 9.98) ms, P <0.01], MPI decreased [(0.61 ± 0.14): (0 .4 4 ± 0.12), P <0.01; (0.6 ± 0.14): (0.474 ± 0.13), P <0.05. There was a positive correlation between MPI and IRT (r = 0.80, P <0.01), but not with LVMI (r = -0.095, P> 0.05). Conclusion: Losartan can improve left ventricular function in elderly patients with EH. MPI reflects the cardiac systolic and diastolic function, which is not affected by left ventricular configuration, systolic dysfunction in patients with hypertension is a reflection of early indicators of left ventricular dysfunction.