内科

目的探讨培哚普利降压治疗对老年轻中度高血压患者颈动脉内-中膜厚度（IMT）、肾功能以及心脏结构与功能的影响。方法选取50例老年原发性轻中度高血压患者，经培哚普利（4～8 mg）治疗血压达标后，维持剂量治疗，随访0.5～1年。检测分析患者IMT、肾功能以及心脏结构和功能的变化情况。结果原发性轻中度高血压患者服用培哚普利半年后，收缩压显著下降（P＜0.05）；而治疗1年后，收缩压、舒张压均显著下降（P＜0.05）；脉压治疗前后比较差异无统计学意义（P＞0.05）；24 h动态血压（包括收缩压及舒张压）在治疗半年及一年后显著下降（P＜0.01）。治疗半年、1年后，患者IMT明显降低（P均＜0.05）；尿β2微球蛋白（β2M）、微量白蛋白（mALB）、血肌酐显著下降（P均＜0.01）。室间隔厚度（IVST）、左室后壁厚度（PWT）、二尖瓣最大舒张期血流测定E峰速度（PEV）、左心室重量指数（LVMI）和左室射血分数（EF）的均值治疗前后比较差异无统计学意义（P＞0.05）；治疗半年、1年后，患者二尖瓣最大舒张期血流测定A峰速度（PAV）明显低于治疗前（P＜0.05）；E/A比值显著升高（P均＜0.01）。结论培哚普利治疗对原发性轻中度高血压患者的颈动脉IMT、肾功能以及心脏的舒张功能有明显改善作用。

ObjectiveTo observe the effect of perindopril on carotid artery intima media thickness (IMT), renal function, and cardiac structure and function in elderly patients with mild-to-moderate hypertension. MethodsFifty elderly patients with mild-to-moderate primary hypertension were enrolled and treated with perindopril (4～8 mg). The dosage of perindopril was maintained when the blood pressure met the requirements. All the patients were followed up for 0.5～1 year. The changes of IMT, renal function, and cardiac structure and function were recorded. ResultsAfter six-month treatment, systolic blood pressure significantly decreased (P＜0.05). After one-year treatment, both systolic blood pressure and diastolic blood pressure significantly decreased (P＜0.05). There was no significant difference in pulse pressure before and after treatment（P＞0.05）. 24h ambulatory systolic blood pressure (including systolic blood pressure and diastolic blood pressure) greatly decreased after six-month and one-year treatment (P＜0.01). After six-month and one-year treatment, the IMT, Urinary β2 microglobulin (β2M), and albumin (ALB) significantly decreased (all P＜0.05, all P＜0.01, and all P＜0.01). There were no significant differences in interventricular septum thickness (IVST), left ventricular posterior wall thickness (PWT), E-wave velocity measurement (PEV), and left ventricular ejection fraction (LVEF) before and after treatment. ConclusionsPerindopril can greatly improve carotid IMT, renal function and the diastolic function of heart in patients with mild-to-moderate primary hypertension.