贝那普利对原发性高血压患者血浆同型半胱氨酸水平和血管内皮功能的影响

目的研究贝那普利对原发性高血压患者血浆同型半胱氨酸（Hcy）水平和血管内皮功能的影响。方法原发性高血压患者77例，随机分为贝那普利组（40例）与常规治疗组（37例），另设健康对照组80例，贝那普利组与常规治疗组均限盐、低钠饮食、适当锻炼、减轻体重血压不迭标的常规治疗组口服利尿剂氢氯噻嗪治疗，贝那普利组给予贝那普利10mg，每日1次口服，治疗8周。比较治疗前后血浆Hcy、一氧化氮（NO）、血管性假性血友病因子（YWF）水平变化，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浆Hey水平明显高于健康对照组，贝那普利治疗后与治疗前比较，Hcy、vwF水平均降低，差异均有显著性（均P〈0．001）；NO、FMD明显升高（均P〈0．001），基础状态下肱动脉内径治疗后有减少趋势，但差异无显著性。常规治疗组治疗前后各指标比较，差异无显著性（P〉0．05）。结论原发性高血压患者Hcy水平明显高于健康对照组。贝那普利降压治疗同时可以降低Hcy水平，改善高血压患者的血管内皮功能。

Effects of Benazepril on plasma homocysteine and endothelial function in patients with essential hypertension

Objective To observe the effects of Benazepril on plasma homocysteine(Hcy) and endothelial function in patients with essential hypertension(EH).Methods 77 cases of EH were randomly divided into two group:40 cases with treatment of Benazepril and 37 cases with routine treatment.80 healthy subjects were taken as control group.The Benazepril group received benazepril 10 mg/d for 8 weeks in addition to routine treatment,including limiting salt,low natrium diet,proper exercise,weight loss and oral diuretic.Before and after the treatment,plasma homocysteine and nitrous oxide (NO),and von willber factor(vWF) were assessed by biochemical assay,and the diameter of brachial artery and brachial artery flow-mediated dilatation (FMD)function was measured by high-resolution vascular ultrasonography.Results Hcy levels in EH patients was significantly higher than in those healthy control group,which was decreased by benazepril and vWF were also decreased(P<0.001),NO and FMD were increased (P<0.001).No significant difference in the diameter of brachial artery was found between groups (P>0.05) .Conclusion The levels of plasma homocysteine are higher in patients with essential hypertension than those of healthy controls.Benazepril may reduce plasma homocysteine and improve endothelial function in the patients with essential hypertension.