厄贝沙坦氢氯噻嗪对肱动脉内皮功能及颈动脉内膜中层厚度的影响

目的观察厄贝沙坦氢氯噻嗪对高血压患者肱动脉内皮功能及颈动脉内膜中层厚度的影响。方法选择2010年6月~2013年2月在徐州医学院附属医院老年科就诊的1级、2级原发性高血压患者137例,完成本研究127例,随机分为氢氯噻嗪组60例及厄贝沙坦氢氯噻嗪67例。2组患者每日晨起分别口服氢氯噻嗪25 mg及厄贝沙坦氢氯噻嗪1片,连续12个月。检测2组患者治疗前后血压、血脂、高敏C反应蛋白(hs-CRP)等指标,以及肱动脉内皮依赖性舒张功能(EDD)和颈动脉内膜中层厚度(IMT)的变化。结果与治疗前比较,氢氯噻嗪组和厄贝沙坦氢氯噻嗪组治疗后收缩压(156.49±9.10)mm Hg vs.(126.37±8.12)mm Hg,(157.26±8.91)mm Hg vs.(124.46±8.07)mm Hg]、舒张压(98.73±5.54)mm Hg vs.(77.65±5.42)mm Hg,(99.54±5.38)mm Hg vs.(76.36±5.71)mm Hg]均降低,差异具有显著统计学意义(P均0.01)。与治疗前比较,厄贝沙坦氢氯噻嗪组患者治疗后内皮依赖性舒张功能(5.37±0.91)%vs.(6.79±1.08)%,P0.01]提高,颈动脉内膜中层厚度(1.16±0.25)mm vs.(1.03±0.20)mm,P0.05]降低。与氢氯噻嗪组患者治疗后比较,厄贝沙坦氢氯噻嗪组患者治疗后内皮依赖性舒张功能(5.56±0.99)%vs.(6.79±1.08)%,P0.01]提高,颈动脉内膜中层厚度(1.15±0.19)mm vs.(1.03±0.20)mm,P0.05]下降。结论厄贝沙坦氢氯噻嗪降压的同时可以改善肱动脉内皮功能、减少颈动脉内膜中层厚度。

Influences of irbesartan hydrochlorothiazide on brachial endothelial function and carotid artery intima-media thickness

Objective To observe the influences of irbesartan hydrochlorothiazide on brachial artery endothelial function and carotid artery intima-media thickness （CA-IMT） in hypertensive patients. Methods The patients （n=137） with grade 1 or grade 2 hypertension were chosen from Jun. 2010 to Feb. 2013, among them 127 had completed this study and randomly divided into hydrochlorothiazide group （group 1, n=60） and irbesartan hydrochlorothiazide group （group 2, n=67）. The patients in 2 groups were respectively given orally hydrochlorothiazide （25 mg） or irbesartan hydrochlorothiazide tablet （1 tablet） in every morning for 12 m. The changes of blood pressure （BP）, blood fat, high-sensitivity C-reactive protein （hs-CRP）, endothelium-dependent dilatation （EDD） and CA-IMT were detected before and after treatment. Results Compared with those before treatment and in 2 groups, systolic BP （156.49±9.10） mmHg vs. （126.37±8.12） mmHg, （157.26±8.91） mmHg vs. （124.46±8.07） mmHg], and diastolic BP （98.73± 5.54） mmHg vs. （77.65±5.42） mmHg, （99.54±5.38） mmHg vs. （76.36±5.71） mmHg] decreased after treatment （all P〈0.01）. EDD （5.37±0.91）%vs. （6.79±1.08）%, P〈0.01] increased and CA-IMT （1.16±0.25） mm vs. （1.03±0.20） mm, P〈0.05] decreased in group 2 compared with those before treatment. Compared with group 1, EDD （5.56±0.99）%vs. （6.79±1.08）%, P〈0.01] increased and CA-IMT （1.15±0.19） mm vs. （1.03±0.20） mm, P〈0.05] decreased in group 2 after treatment. Conclusion Irbesartan hydrochlorothiazide can improve brachial artery endothelial function and reduce CA-IMT at the same time of decreasing BP.