两种降压方案对老年原发性高血压患者内皮功能改善的影响

目的分析不同的降压方案对老年原发性高血压患者内皮功能改善的影响。方法入选86例老年高血压患者,随机分为替米沙坦组和阿米洛利组,每组43例,2组均在服用氨氯地平基础上,分别加服替米沙坦和阿米洛利治疗1年,观察治疗前后患者内源性哇巴因(EO)、血管性血友病因子(vWF)、NO、内皮素1(ET-1)水平及血管内皮依赖性舒张功能和动态血压的变化。结果与治疗前比较,2组治疗后血压均明显下降(P<0.01);EO水平无明显变化(P>0.05);vWF和ET-1明显下降(P<0.01);NO明显增高(P<0.05),除NO外,替米沙坦组较阿米洛利组上述各项指标降低更明显(P<0.01)。2组的血管内皮依赖性舒张功能均较治疗前明显提高(P<0.01)。结论 2种降压方案均适用于老年高血压患者,可起到内皮保护作用,但是对靶器官的保护是一个持续的过程。

The effects of two hypotensor regimens on endothelial function in old patients with primary hypertension

Objective To compare the effects of two different hypotensor regimens on endothelial function in old patients with primary hypertension.Methods Eighty-six old hypertensive patients were divided into telmisartan group and amiloride group randomly.The serum levels of endogenous ouabain(EO),von Willebrand-factor(vWF),nitric oxideCNO) and endothelin-1(ET-1) were detected,endothelium-dependent relaxing function of brachial artery was examined by high-resolution ultrasound,and ambulatory blood pressure was measured before and after 1-year treatment. Results Compared with before treatment,blood pressure was evidently reduced and flow-mediated vasodilation of brachial artery was increased in both groups after 1-year treatment.EO level had no significant change.The serum vWF and ET-1 levels were decreased in both groups, but they decreased more significantly in telmisartan group than in amiloride group.NO level was increased markedly after treatment and there was no difference between the two groups.Conclusion The blood pressure of old hypertensive patients was reduced and endothelium function was protected after treatment with suitable combination of amlodipine with amiloride or telmisartan, but the target organ protection was a persistent process.