摘要
目的:探讨临床常用抗高血压利尿剂吲达帕胺缓释片对轻、中度原发性高血压病人血管内皮功能的影响。方法:用高分辨率超声检测经吲达帕胺缓释片(1.5mg,po,qd或bid)或西拉普利(2.5mg,po,qd或bid)治疗8wk前后的高血压病人肱动脉血流介导的扩张值(FMD)和硝酸甘油介导的扩张值(NMD)的变化,同时测定血浆内皮素1(ET-1)和血管性假血友病因子(vWF)的浓度,并以17例健康者作为对照。结果:高血压病人FMD显著低于正常人(P<0.01),NMD无显著差异(P>0.05)。高血压病人ET-1和vWF浓度显著高于正常人(P<0.05)。高血压病人经西拉普利治疗8wk后FMD显著改善[(7.9±s1.7)%vs(5.4±1.2)%,P<0.01],同时ET-1浓度[(59±10)ng·L-1vs(67±10)ng·L-1,P<0.05]和vWF浓度[(121±26)%vs(140±29)%,P<0.05]均显著降低;病人经吲达帕胺缓释片治疗后,FMD显著改善[(7.7±1.4)%vs(5.8±1.9)%,P<0.01],ET-1浓度显著下降[(57±10)ng·L-1vs(69±11)ng·L-1,P<0.05],vWF浓度虽然也降低,但未达到统计学意义[(128±24)%vs(142±31)%,P>0.05]。直线相关性检验发现,FMD与收缩压呈显著负相关(P<0.05),ET-1浓度与收缩压及舒张压均呈显著正相关(P<0.05)。结论:轻、中度原发性高血压病人存在内皮依赖性舒张功能障碍,并有血浆ET和vWF因子浓度升高。血压的升高对内皮功能有一定影响。吲达帕胺缓释片能显著改善轻、中度原发性高血压病人内皮依赖性舒张功能,并使血浆ET浓度显著降低。
AIM： To investigate the effects of indapamide sustained release （SR） tablets on vascular endothelial function in patients with moderate essential hypertension. METHODS： Flow-mediated endothelium dependent dilation （FMD） and nitroglycerin-mediated dilation （NMD） were assessed by high resolution ultrasound technique in the brachial artery of 17 or 18 patients with essential hypertension treatment using indapamide SR tablets or cilazapril for 8 wk, respectively. Concentration of endothelin-1 （ ET - 1 ） and von- Willbrand factor（vWF） were determinated at the same time. Serenteen healthy cases were taken as controls. RESULTS： FMD values in healthy controls were higher than hypertensive patients before treament （P 〈 0.01 ）. No significant differences were found in NMD. After treatment with cilazapril for 8 wk, the FMD values improved significantly compared with before treatment （（7.9 ±s 1.7） % vs （5.4 ±1.2） %, P〈 0.01 ）,while concentration of ET-1 （（59 ± 10） ng · L^-1 vs （67 ±10） ng· L^-1, P〈0.05） and vWF （（121±26） % vs （140 ±29） %, P〈0.05） decreased significantly. After treatment with indapamide SR tablets for 8 wk, the FMD values improved significantly compared with before treatment （（ 7. 7 ± 1.4） % vs （5.8 ±1.9） %, P〈0.01）,while concentration of ET-1 decreased significantly （ （57 ± 10） ng. L-lvs （69±11） ng· L^-1, p〈0.05）. The concentration of vWF also decreased , but with no significance （（128±24） % vs （142±31） %, P〉0.05）. FMD was negatively correlated with SBP significantly, while ET-1 was positively correlated with SBP and DBP significantly. CONCLUSION ： Endothelium-dependent dilation is impaired in hypertenvie patients with ET and vWF increasing. Indapamide SR can improve endothelium-dependent dilation and decrease endothelin in patients with essential hypertension.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2005年第9期733-736,共4页
Chinese Journal of New Drugs and Clinical Remedies
