替米沙坦治疗老年原发性高血压患者的临床效果

目的观察替米沙坦治疗老年原发性高血压（EH）患者的临床效果。方法选择2012年6月～2014年1月来河南省人民医院就诊的EH患者60例作为替米沙坦组（替米沙坦80 mg,1次/d,疗程6个月）和同期健康体检老年人30例作为正常对照组;对正常对照组和替米沙坦组治疗前和治疗6个月后分别空腹采血。通过血压计测量收缩压和舒张压水平;采用免疫比浊法检测血清中超敏C反应蛋白（hs-CRP）的含量;采用全自动血凝分析仪检测血清中纤维蛋白原（FIB）的含量;采用ELISA法检测血清中白细胞介素6（IL-6）、白细胞介素18（IL-18）、细胞间黏附分子-1（ICAM-1）和肿瘤坏死因子-α（TNF-α）的蛋白水平。结果替米沙坦组治疗前与正常对照组比较,血清hs-CRP、FIB、IL-6、IL-18、ICAM-1和TNF-α的含量明显增高,差异有高度统计学意义（P〈0.01）。替米沙坦组治疗6个月后与正常对照组比较,血清hs-CRP、FIB、IL-6、IL-18、ICAM-1和TNF-α的含量略增高,差异有统计学意义（P〈0.05）;与治疗前比较,血清hs-CRP、FIB、IL-6、IL-18、ICAM-1和TNF-α的含量明显降低,差异有高度统计学意义（P〈0.01）。结论老年EH患者体内存在炎性反应,炎症因子参与了老年原发性高血压患者发病的病理生理过程;替米沙坦能通过降低血清hs-CRP、FIB、IL-6、IL-18、ICAM-1和TNF-α的蛋白水平,起到降压作用和抗炎作用。

Clinical effect of Telmisartan in treatment of elderly patients with essential hypertension

Objective To observe the effect of Telmisartan in treatment of elderly patients with essential hypertension（EH） in patients with clinical efficacy. Methods 60 EH patients in He＇nan Provincial People＇s Hospital from June 2012to January 2014 were selected as Telmisartan group（Telmisartan 80 mg, once a day, course of 6 months） and 30healthy elderly people physical examined at the same time were selected as normal control group; everyone was fasting blood at initial examination and Telmisartan group were fasting blood 6 months later. The systolic and diastolic blood pressure were measured with sphygmomanometer; the high-sensitivity C reactive protein（hs-CRP） was detected with immunonephelometry; the serum fibrinogen（FIB） was detected with the fiber automatic blood coagulation analyzer;serum interleukin 6（IL-6）, interleukin 18（IL-18）, intercellular adhesion molecule-1（ICAM-1） and tumor necrosis factor alpha（TNF-α） protein levels were detected with the method of ELISA. Results In initial examination,Telmisartan group compared with the normal control group, the content of serum hs-CRP, FIB, IL-6, IL-18, ICAM-1and TNF- α increased with a statistical significance（P〈0.01）. The content of serum hs-CRP, FIB, IL-6, IL-18,ICAM-1 and TNF- α slightly increased with a statistical significance after treatment of 6 months＇ later compared with the normal control group（P 0.05）; after treatment with Telmisartan, the contents of serum hs-CRP, FIB, IL-6, IL-18,ICAM-1 and TNF-α markedly reduced with a statistical significance（P〈0.01）. Conclusion Inflammation reaction exists in elder EH patients, inflammatory factors involved in the pathophysiological process of senior primary pathogenesis of hypertension; Telmisartan can reduce the protein level of serum hs-CRP, FIB, IL-6, IL-18, ICAM-1and TNF-α, the antihypertensive effect and anti-inflammatory effects.