缬沙坦对伴有高血压病的代谢综合征患者血管性假血友病因子的影响

目的 观察伴有高血压病的代谢综合征（metabolic syndrome，MS）患者血浆血管性假血友病因子（von Willebrand factor,vWF）水平及应用缬沙坦后vWF的变化。方法 测定22例伴有高血压病的MS患者服用缬沙坦80 mg/d4周前后及29例健康体检者血浆vWF含量。结果 伴高血压病的MS患者血浆vWF显著高于健康对照者［(176±24)% vs (130±26)%，P<0.01］；vWF含量与收缩压（SBP）［r＝0.60，P<0.01］、舒张压（DBP）［r＝0.57，P<0.01］、平均动脉压（MAP）［r＝0.61，P<0.01］、体质量指数（BMI）［r＝0.53，P<0.01］、三酰甘油（TG）［r=0.36，P<0.05］、总胆固醇（TC）［r=0.49，P<0.01］、空腹血糖（FBG）［r＝0.45，P<0.01］呈正相关；缬沙坦治疗4周后，伴高血压病的MS患者血浆vWF水平较治疗前显著降低［(160±15)% vs (176±24)%，P<0.01］。结论 伴高血压病的MS患者血浆vWF水平较健康人明显增高；予缬沙坦治疗后，在有效降低血压的同时，可短期内降低vWF水平，改善血管内皮功能。

Effect of valsartan on the level of vWF in patients with hypertension and metabolic syndrome

AIM To observe the plasma level of von Willebrand factor (vWF) in patients with hypertension and metabolic syndrome (MS) and to measure the changes of vWF after valsartan administration. METHODS The plasma level of vWF was determined in 22 hypertensive patients with MS before and after valsartan at a dose of 80 mg once daily for 4 weeks and in 29 healthy objects. RESULTS The plasma level of vWF in patient group was significantly higher than that in the control group ［(176±24)% vs (130±26)%, P<0.01］. The plasma level of vWF had positive correlation with SBP （r＝0.60, P<0.01）, DBP(r＝0.57, P<0.01), MAP(r＝0.61, P<0.01), BMI（r＝0.53, P<0.01）, TG(r＝0.36, P<0.05), TC(r=0.49, P<0.01) and FBG（r＝0.45, P<0.01）. After 4 weeks’ treatment with valsartan, the plasma vWF in patients with hypertension and MS diminished significantly ［(160±15)% vs (176±24)%, P<0.01］. CONCLUSION The plasma level of vWF in patients with MS and hypertension is significantly higher. Valsartan not only controls the blood pressure but also decreases the plasma vWF in a short-term treatment and improves the endothelial function.