缬沙坦对高血压合并糖尿病患者血压及血管内皮功能的影响

Effect of valsartan on endothelium-dependent relaxing function in hypertensive patients with type 2 diabetes mellitus

目的:研究缬沙坦对原发性高血压合并2型糖尿病患者血压及血管内皮依赖性舒张功能的影响。方法:23例高血压合并2型糖尿病患者服用缬沙坦片80-160mg/d,测定治疗前及治疗后3、6个月体重指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FBG)、餐后2h血糖(2h-PBG)、收缩压(SBP)、舒张压(DBP)及右肱动脉内径基础值(D0)和反应性充血、含服硝酸甘油后右肱动脉内径的变化率(△D1、△D2),并对治疗前后各指标的变化进行了比较。结果:(1)治疗后3、6个月与治疗前相比,BMI、TC、TG、FBG、2h-PBG均无明显变化(P均>0.05)。(2)治疗后3、6个月SBP、DBP均较治疗前明显降低(P均<0.01),而治疗后6个月与3个月相比,血压降低更为明显(P<0.05)。(3)治疗后3、6个月反应性充血后右肱动脉内径变化率均较治疗前明显改善(P均<0.05),但治疗后6个月较3个月无进一步改善。结论:缬沙坦治疗原发性高血压合并2型糖尿病在降压同时可有效改善血管内皮依赖性舒张功能,且降压效果呈现时间依赖性。

Objective： To investigate the effect of valsartan on blood pressure and endothelium-dependent relaxing function in essential hypertensive patients with type 2 diabetes mellitus. Methods： We measured body mass index（BMl）, total cholesterol（TC）, triglyceride（TG）, fasting blood glucose（FBG）, postprandial blood glucose（2 h-PBG）, systolic blood pressure（SBP）, diastolic blood pressure （DBP） and fundamental inner diameter of brachial arteries（D0）, diameter in brachial arteries in responding to reactive hyperaemia and after suming glyceryltrinitrate（△D1 , △D2）of 23 essential hypertensive patients with type 2 diabetes mellitus before and after treated withvalsartan80-160 mg/d for 3 and 6 months. Results： （1） After treatment, BMI, TC, TG, FBG, 2 h-PBG showed no marked change. （2） After treatment for 3, 6 months, SBP and DBP were all cut down obviously than before, and that of 6 months gained further degrade than 3 months. （3） After 3, 6 months, AD1 were improved greatly than before treatment, but after 6 months had no obvious amendment than that after 3 months. Conclusions： Valsartan may improve endothelium-dependent vasodilation in hypertensive patients with type 2 diabetes mellitus besides antihypertension therapy, and the effect of depressurization seems to be time-dependent.