卡托普利对高血压患者血清脂联素水平和血管内皮功能的影响

目的:研究卡托普利对原发性高血压患者血清脂联素水平和血管内皮功能的影响。方法:93例原发性高血压患者随机分为治疗组(49例)与对照组(44例),另设健康组85例。治疗组在对照组限盐低钠饮食、适当锻炼、减轻体重、口服利尿剂治疗的基础上加服卡托普利25mg,3次·d-1,治疗16wk。比较治疗前、后血清脂联素、一氧化氮(NO)、血管性假性血友病因子(vWF)水平的变化,超声测量肱动脉血流依赖性舒张功能(FMD)、肱动脉内径。结果:原发性高血压患者血清脂联素水平明显低于正常人;治疗组治疗后与治疗前比较,血清脂联素水平升高,NO浓度升高,FMD明显升高,vWF水平降低,均有统计学意义(P<0．05或P< 0．001),基础状态下肱动脉内径治疗后有减少趋势,但无统计学意义;对照组治疗前、后比较,变化无统计学意义(P>0．05)。结论:卡托普利降压同时可提高血清脂联素水平,改善高血压患者的血管内皮功能。

Effects of Captopril on Serum Adiponectin and Endothelial Function in Patients with Essential Hypertension

OBJECTIVE: To study the effect of Captopril on serum adiponectin and endothelial function in patients with essential hypertension .METHODS: Ninety three patients with essential hypertension were randomized to trial group(49 cases) and control group(44 cases),besides,another healthy group(85 cases) wasestablished .Both the trial group and the control group were treated with low sodium diet, proper exercises, weight reduction and oral administration of diuretics, however, the trial group was treated additionally with Captopril 25 mg tid for 16wk.Before and after the treatment, levels of serum adiponectin, nitrous oxide(NO) and von Willebrand' s factor(vWF) were assayed, and the internal diameter of brachial artery and brachial artery flow - mediated dilatation(FMD) function was measured.RESULTS: Serum adiponectin level in patients with essential hypertension was significantly lower than in normal healthy patients.In trial group, levels of serum adiponectin and NO increased and FMD increased significantly, while vWF decreased as compared with before treatment, all were noted to be of significances(P<0.05 or P<0.001); under basic condition, the diameter of brachial artery diminished a little after treatment but of no significant difference.No significance was found in the control group after treatment as compared with before treat-ment(P>0.05) .CONCLUSION:Captopril can enhance serum adiponectin level and improve endothelial function in decreasing the blood pressure of patients with essential hypertension.