西尼地平对高血压病人血清C反应蛋白含量和颈动脉内膜-中膜厚度的影响

目的研究C反应蛋白（CRP）在高血压病人中的作用和西尼地平的影响。方法观察87例不同病程的高血压病人使用西尼地平前后血清hs-CRP的变化，同时使用多普勒观察颈动脉内径（ID）和内膜-中膜厚度（IMT）的变化，直线相关分析hs—CRP与血压、IMT、ID和IMT／ID比值的关系。结果西尼地平可以降低高血压病人血压，同时降低hs—CRP、IMT和IMT／ID，升高ID；分析病程〈3年高血压病人，hs-CRP随病程的增加而增加；但随着病程的进一步增加（≥3年与〉5年相比），hs—CRP并无统计学意义的增加；IMT、ID和IMT／ID也呈现同样的规律。hs-CRP、IMT和IMT／ID随收缩压的增加而增加。多元相关回归分析显示，影响IMT的主要因素为CRP和高血压的病程。结论CRP参与早期高血压的发生发展，炎症因素参与高血压的血管重塑。西尼地平可以改善高血压血管重塑。

Cilnidipine on serum C-reactive protein and carotid intima-media thickness in hypertensive patients

Objective To assess wh et her circulating levels of high sensitivity C-reactive protein(hs-CRP)are rel ated to essential hypertension and the effects of cilnidipine on hypertensive pa tients.Methods A total of 87 outpatients(aged from 18 to 65 ye ars)treated with cilnidipine were enrolled.The changes in serum hs-CRP concen tration,carotid intima-media thickness(IMT),intima diameter(ID)and IMT/ID ra tio compared with those before therapy were observed.The hs-CRP was determined by nephelometry and carotid IMT and ID was measured b y ultrasonography.Linear correlation analysis of the relationships between hs-CRP and blood pressure(BP),IMT,ID and IMT/ID ratio was performed.Multiple re gression analysis of relations between IMT and the risk factors,including hs-C RP,body weight index,age,blood lipids,blood glucose and course of hypertension was done.Results BP,IMT and IMT/ID were decreased and ID was in creased after cilnidipine therapy.Within 3 years,hs-CRP,IMT and IMT/ID increa sed and ID decreased with progression of hypertension,whereas hs-CRP,IMT and I MT/ID did not increase and ID did not decrese with further progression of hypert ension.The hs-CRP level,IMT and IMT/ID ratio increased with increasing systoli c blood pressure.Multiple regression analysis revealed that changes in IMT were mainly related to serum hs-CRP concentration and course of hypertension.Conclusions The results suggest that the CRP may be associated with th e development of early hypertension,and support the possible role of hypertensi on as an inflammatory stimulus contributing to vascular remodeling.Cilnidipine can improve vascular remodeling in patients with hypertension.