缬沙坦改善原发性高血压患者血管内皮功能

Valsartan Improves Endothelial Function in Essential Hypertension Patients

目的探讨缬沙坦对原发性高血压患者血管内皮功能的影响。方法36例原发性高血压患者口服缬沙坦80mg,1次/d。治疗8周前后,采用高分辨血管外超声法测定治疗前后肱动脉内皮依赖性血管舒张功能;采用硝酸还原法测定血清一氧化氮(NO),化学比色法测定血清超氧化物岐化酶(SOD)及丙二醛(MDA)即脂质过氧化物(LPO)浓度。选择26例正常人作为对照组。结果治疗前反应性充血引起的肱动脉变化与正常对照组比较明显减弱P<0.01,治疗后明显改善P<0.01。服用缬沙坦前与正常对照组的NO水平比较P<0.01,治疗后与治疗前相比较具有明显的提高P<0.01。治疗前与对照组相比SOD活性较对照组明显降低(P<0.01),MDA活性明显增高(P<0.01),经缬沙坦治疗后SOD活性较治疗前明显增高(P<0.01),MDA活性明显降低(P<0.01)。单因素相关分析显示:原发性高血压患者在进行缬沙坦治疗后反应性充血时肱动脉内径的变化与NO水平呈线性正相关P<0.01,r=0.798。结论缬沙坦可改善血管内皮依赖性舒张功能,减少氧化应激。

Objective To evaluate the effect of valsartan on endothelial function in patients with essential hypertension. Methods Thirty six patients of essential hypertension recieved valsartan（80 rag/d） for 8 weeks. After treatment, serum NO, SOD and MDA were measured using chemically colorimetric method. Brachial artery endothelium-dependent dilation function（FMD） was determined by high resolution uhrasonography. Twenty six health adults served as controls. Results Compared with the control, FMD was significantly decreased （P〈0.01） but improved obviously after the treatment （P〈0.01）. NO level was lower in the group of essential hypertensio.n than that in the normal control （P〈0. 01）, which was significantly increased after treatment （P〈0.01）. SOD activity was significantly lower than that of normal control （P〈0.01） , whereas MDA was increased （P〈0.01）. After the treatment, SOD activity was increased greatly （P〈0.01）, along with decreases in MDA （ P〈0.01 ）. Correlation analysis showed a positive correlation between NO level and the changes in FMD after the treatment of valsartan （P 〈0.01 ）. Conclusion Valsartan treatment improve brachinal endothelium-dependent dilatation function and decrease the oxidative stress in patients with essential hypertension.