天麻素注射液对老年难治性高血压患者血压和血管活性物质影响的随机对照研究

目的：检测并比较老年难治性高血压患者血浆内皮素（endothelin，ET）和一氧化氮（nitric oxide，NO）含量变化．观察天麻素注射液对老年难治性高血压患者血压及血浆ET和NO含量的影响。方法：选取老年难治性高血压患者63例，普通高血压患者30例，健康人群30例，检测并比较其血浆ET和NO含量变化；将难治性高血压患者随机分为2组：天麻素治疗组和常规治疗组。天麻素治疗组在常规治疗的基础上加用天麻素注射液1000mg静脉滴注2个疗程，共4周，常规治疗组继续常规降压药物治疗，观察治疗前和每个疗程后血压的变化，并比较血浆ET和NO含量的变化。结果：难治性高血压患者血浆ET含量明显高于普通高血压者（t=3．27，P=0．008），NO含量明显低于普通高血压者（t=-3．81．P=0．002）。天麻素治疗组患者在治疗1个疗程后收缩压和脉压差均明显下降（t=1．85，P=0．03；t=1．74．P=0．04）。天麻素治疗组随着治疗疗程的增加，ET含量逐渐下降，但2个疗程结束后与治疗前相比，差异仍无统计学意义；而NO含量在2个疗程结束后明显升高，与治疗前相比．差异有统计学意义（t=-2．70，P=0．04）。结论：与普通高血压患者比较，难治性高血压患者血浆ET明显升高，NO含量显著降低。天麻素注射液可以降低老年难治性高血压患者的血压，且其降低收缩压的作用相对较强。可能通过调节患者血管活性物质来实现降压，但具体机制尚需进一步研究。

Effects of gastrodin injection on blood pressure and vasoactive substances in treatment of old patients with refractory hypertension: a randomized controlled trial

Objective: To examine and determine the contents of endothelin (ET) and nitric oxide (NO) in plasma, and to observe the effects of gastrodin injection on blood pressure, ET and NO levels in old patients with refractory hypertension. Methods: A total of 63 old patients with refractory hypertension, 30 patients with common hypertension and 30 healthy people were included. The contents of ET and NO in plasma of patients in different groups and healthy people were examined and analyzed. The old patients with refractory hypertension were randomly divided into two groups: gastrodin-treated and routine treatment groups. Besides conventional hypotensive drugs, intravenous drip infusion of 1 000 mg gastrodin was administered to the patients in gastrodin-treated group for two courses (4 weeks), while the patients in routine treatment group were treated only with conventional hypotensive drugs. The changes of blood pressure, ET and NO levels before and after treatment in different groups were measured. Results: The plasma level of ET in refractory hypertension group was higher than that in common hypertension group (t=3.27, P=0.008), while the level of NO was lower (t=-3.81, P=0.002). The systolic pressure and pulse pressure difference in gastrodin-treated group were decreased significantly after one course of treatment (t=1.85, P=0.03; t=1.74, P=0.04). The level of ET in gastrodin-treated group decreased gradually after treatment, but there were no significant difference between before treatment and two courses of treatment, while the level of NO in gastrodin-treated group was increased after treatment (t=-2.70; P=0.04). Conclusion: Gastrodin injection is beneficial to old patients with refractory hypertension, and can improve the balance of ET and NO levels in plasma.