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目的:探讨缬沙坦对原发性高血压(EH)患者心肌纤维化及左室舒张功能的影响。方法:分别于治疗前后用放射免疫法测定EH患者血清的中Ⅲ型前胶原(PCⅢ)及血浆血管紧张素Ⅱ含量,用超声心动图测量EH患者心脏左室舒张功能各主要指标的变化并与26例对照组进行比较。结果:治疗前EH患者血清PCⅢ含量均高于对照组(P<0.05),治疗后①血压均显著下降(P<0.05),左室舒张功能指标E、E/A上升(P< 0.05),A下降(P<0.05);②高血压伴左室肥厚组心肌重量指数明显下降(P<0.05),血清PCⅢ水平也有显著下降(P<0.05),但未降至正常。③高血压不伴左室肥厚组:血清PCⅢ水平降至正常(P<0.05)。结论:血清PCⅢ水平是反映EH患者心肌胶原合成活跃程度与心肌纤维化的早期、敏感指标。缬沙坦有助于减轻心肌纤维化的程度,改善左室舒张功能。
Objective: To investigate the effects of valsartan on myocardial fibrosis and left ventricular diastolic function in patients with essential hypertension (EH). Methods: Serum levels of type Ⅲ procollagen (PC Ⅲ) and plasma angiotensin Ⅱ in patients with EH were measured by radioimmunoassay before and after treatment. Echocardiography was used to measure the change of cardiac left ventricular diastolic function in patients with EH. 26 cases of control group for comparison. Results: The levels of PCⅢ in patients with EH before treatment were significantly higher than those in the control group (P <0.05). After treatment, the blood pressure was significantly decreased (P <0.05) and the left ventricular diastolic function indexes E and E / A increased (P <0.05) (P <0.05); ② The myocardial weight index of hypertensive patients with left ventricular hypertrophy was significantly decreased (P <0.05) and the level of serum PCⅢ was also significantly decreased (P <0.05), but not decreased to normal. ③ hypertension without left ventricular hypertrophy group: serum PC Ⅲ levels decreased to normal (P <0.05). Conclusion: Serum PCⅢ level is an early and sensitive index reflecting the degree of myocardial collagen synthesis activity and myocardial fibrosis in EH patients. Valsartan helps to reduce the extent of myocardial fibrosis and improve left ventricular diastolic function.