左旋氨氯地平对高血压患者血清hs-CRP和血管内皮功能的影响

目的观察左旋氨氯地平对原发性高血压(高血压)患者血清高敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)和血管内皮功能的影响。方法 90例高血压患者分为3组:氨氯地平组(A组,30例,接受氨氯地平治疗);吲达帕胺组(B组,30例,接受吲达帕胺治疗);联合治疗组(C组,30例,接受氨氯地平和吲达帕胺治疗)。入选前所有对象均未接受降压降脂治疗或服药者停用4周以上,并于治疗前后监测血压、血清hs-CRP浓度、内皮素(endothelin,ET)及肱动脉内皮功能的变化。同时与24例正常对照组比较。结果与对照组比较,A、B、C组高血压患者hs-CRP、ET浓度显著升高(P0.05)。3组治疗后血压、hs-CRP、ET水平均显著下降(P0.05),以C组下降最明显(P0.01),并且较B组更佳(P0.05);A组与B组比较,差异无统计学意义(P0.05)。肱动脉内皮功能随血压的控制得到明显改善(P0.05),亦以C组改善最明显(P0.01)。结论左旋氨氯地平片降压疗效显著,能降低血清炎症因子hs-CRP、ET浓度,从而明显改善血管内皮功能。联合吲达帕胺应用的效果优于单独使用。

Effect of levoamlodipine on serum high-sensitivity C-reactive protein and vascular endothelial function in patients with hypertension

Objectives To study the effect of levoamlodipine on serum high-sensitivity C-reactive protein （hs-CRP） and vascular endothelial function in patients with hypertension. Methods A total of 90 cases with essential hypertension were divided into three groups ： levoamlodipine group （group A,n=30） ; indapamide group （group B, n=30） ; combined treatment group （group C ,n =30, treated with levoamlodipine and indapamide）. All the objects were suspended receiving antihypertensive therapy or lipid-lowering medication at least more than 4 weeks pre-selected. The blood pressure, plasma hs-CRP and endothelin （ET） and endothelial function were measured before and after treatment. The 24 healthy subjects were selected as control group. Results Compared with the normal control group, concentrations of hs-CRP, ET were significantly higher in three groups of hypertensive patients （P 〈0.05）. Blood pressure, hs-CRP, ET levels were significantly decreased in three groups after treatment （P〈0.05）, in the group C was the most significantly （P〈0.01）, and it was better than the group B （P〈0.05）; Group A and group B had no significant difference（P〉0.05 ）. Brachial artery endothelial function and blood pressure control were significantly improved in three groups （P〈0.05）, and group C was of the most significant （P〈0.01）. Conclusions Levoamlodipiue antihypertensive effect is significant, and can reduce the inflammatory factor hs-CRP, ET, and thus significantly improved endothelial function. Application of the joint effect of indapamide is better than alone.