摘要
目的探讨原发性高血压病合并2型糖尿病患者心脏变时性功能的特点及缬沙坦对其的影响。方法40例原发性高血压病合并2型糖尿病患者设为观察组,用缬沙坦80～160mg/d治疗12周,观察心脏变时性功能并与正常对照组比较。运动中最大心率(MaxHR)未达年龄预测最大心率(220-年龄)的85%和心脏变时指数(CRI)<0.8、心率储备率(HRR)<80%为心脏变时功能不全的诊断指标。结果观察组患者MaxHR(132±22)次/min、CRI0.70±0.20、HRR(57.5%)明显低于对照组(160±17)次/min(t=2.899,P<0.01)、CRI1.22±0.24(t=3.209,P<0.01)、HRR(2.5%)(χ2=28.81,P<0.01);经过缬沙坦每天80～160mg治疗12周后,观察组患者MaxHR(144±18)次/min、CRI0.81±0.21、HRR(37.5%)明显高于治疗前MaxHR(t=2.131,P<0.05)、CR(It=2.024,P<0.05)、HRR(χ2=3.21,P<0.05)。结论观察组患者存在心脏变时性功能不全情况,可能与心脏自主神经受损有关,缬沙坦在降低血压的同时,能有效的提高心脏迷走神经张力,降低交感神经张力,有可能减少心律失常性死亡。
Objective To investigate the effect of valsartan on chronotropic incompetence in hypertensive patients complicated with type 2 diabetes mellitus. Methods Forty hypertensive patients complicated with type 2 diabetes mellitus were treated with valsartan 80-160mg/d for 12 weeks （observation group）, and the changes of chronotropic incompetence were examined in comparison with normal control group. The diagnosis criteria for chronotropic incompetence： movement maximal heart rate （Max HR） 〈 85% of maximal age-predicted heart rate （220-age） ; Heart Variable Index （CRI） 〈0.8 and the ratio of heart rate reserve （HRR） 〈 80%. Results The Max HR （132±22）bpm, CRI 0.70±0.20 and HRR （57.5%） in observation group were significantly lower than those in normal control group [Max HR（160±17）bpm（t=2.899, P〈0.01）]. [CRI 1.22±0.24 （t=3.209,P〈0.01）.HRR （2.5%）（X^2=28.81, P〈0.01 ）. After treated with valsartan 80-160mg/d for 12 weeks, the Max HR（144±18）bpm, CRI 0.81±0.21, HRR （37.5%） were significantly higher than those before treatment Max HR （t=2.131,P〈0.05）, CRI（t=2.024,P〈0.05）, HRR （X^2=3.21,P〈0.05）. Conclusion Valsartan can lower the blood pressure, increase cardiac vagal activity and decrease sympathetic activity, which suggests that valsartan may reduce the arrhythmic mortality.
出处
《浙江医学》
CAS
2008年第2期126-128,共3页
Zhejiang Medical Journal
