氨氯地平对高血压患者大动脉内皮功能和粥样硬化斑块的影响

目的　探讨氨氯地平对高血压病患者大动脉内皮功能和粥样硬化斑块的影响。方法　将高血压病患者随机分为A组 (氨氯地平治疗组 ,n =35 )和B组 (培哚普利治疗组 ,n =35 ) ,另设年龄、性别与之匹配的正常人作为对照组 (C组 ,n =30 )。用高分辨超声技术检测各组对象的肱动脉内皮依赖性舒张功能、颈动脉平均内中膜厚度、颈动脉斑块发生率及Crouse积分。对A、B组分别在治疗 3个月、1年及 2年后复查血压和血管超声的上述指标。结果　与C组比较 ,A组与B组肱动脉内皮依赖性舒张功能减退 ,颈动脉内中膜增厚 (P <0 0 1)。氨氯地平组与培哚普利组在降低血压及改善血管内皮依赖性舒张功能方面作用相同 (P >0 0 5 ) ,但氨氯地平组在逆转颈动脉内中膜厚度、降低新的粥样斑块发生率方面作用优于培哚普利组 (P <0 0 1)。结论　氨氯地平除能有效降低高血压患者的血压外 ,还能逆转大动脉功能和结构异常 ,延缓动脉粥样硬化进展

Effects of amlodipine on endothelial function and atherosclerosis progression of large arteries in hypertensive patients

Objective To investigate the effect of treatment with amlodipine on endothelial function and atherosclerosis progression of large arteries in hypertensive patients Methods The patients with essential hypertension were randomly divided into group A (treatment with amlodipine, n =35) or into group B (treatment with perindopril, n =35) The healthy subjects work as group C (controls group, n =30), whose age and sex were matched with group A and B The humeral arterial endothelium dependent vasodilatation and carotid arterial mean intimal medial thickness (MIMT) and carotid plaques were measured with high resolution ultrasonography for each group For groups A and B, all above indices and blood pressure were measured again after 3 month, 1 year and 2 years of treatment respectively Results Compared with group C, group A and B had lower humeral arterial endothelium dependent vasodilatation and thicker carotid MIMT( P <0 01) There was no difference in reduction of blood pressure and improvement of humeral arterial endothelium dependent vasodilatation between groups A and B( P >0 05) Compared with group B, group A had a significantly better effect on normalizing carotid MIMT and decreasing the incidence of new plaques ( P <0 01) Conclusion In addition to reduction of blood pressure, amlodipine has effect on regression of abnormal function and structure of large arteries, which may delay the progression of atheroclerosis