氯沙坦对高血压病患者血管内皮功能的影响及其临床意义

Effects of Losartan on vascular endothelial function in patients with essential hypertension and its clinical significance

目的探讨氯沙坦对高血压病患者血管内皮功能的影响及其临床意义。方法采用血浆内皮素(ET),一氧化氮(NO),血小板α-颗粒膜蛋白(GMP140)和血管性假血友病因子(vWF)水平作为内皮功能指标,观察45例高血压病患者氯沙坦治疗4周前后血管内皮功能的改变。结果高血压组治疗前血浆ET、vWF和GMP140均显著高于正常对照组,NO/ET较正常对照显著降低(P<0.05,P<0.01)。治疗4周,高血压组的血浆ET、vWF、GMP140较前显著降低(P<0.05,P<0.01)。血浆NO及NO/ET较前显著升高,并且NO显著高于正常对照组(P<0.05,P<0.01)。ET与血总胆固醇(TC)、SBP正相关,NO和NO/ET与空腹血糖、SBP和三酰甘油显著负相关,NO/ET还与HDL正相关,vWF、GMP140与HDL负相关,GMP140与TC正相关(P<0.05,P<0.01)。结论高血压患者存在血管内皮功能减退,内皮功能与收缩压、血糖、血脂相关联。氯沙坦能够改善高血压患者的血管内皮功能。

AIM To investigate the changes of vascular endothelial function in patients with essential hypertension and effects of Losartan on the patients. METHODS The plasma levels of endothelin （ET） , nitric oxide （NO）, von Willebrand Factor （vWF）, and plate t^-granule membrane protein （GMP140） were measured as the indexes of endothelial function. Forty-five patients with essential hypertension were treated with Losartan for 4 weeks and the changes of vascular endothelial function were investigated RESULTS The plasma ET, vWF and GMP140 in hypertensive patients before treatment were significantly higher than those in normal control and NO/ET decreased in hypertensive group （ P 〈 0.05, P 〈 0.01）. After 4 weeks＇treatment, the plasma ET, vWF and GMP140 in hypertensive group were decreased markedly （P 〈0.05 ,P 〈0.01 ）. The plasma NO and NO/ET were increased and NO was higher than that in normal control （P 〈0.05 ,P 〈0.01 ）. ET was positive correlated to blood total cholesterol （TC） and systolic blood pressure （SBP）. NO and NO/ET were negatively related to fasting blood sugar, SBP and triglyceride, while NO/ET was positive correlated to high density lipoprotein （HDL）. GMP140 and vWF were negative correlated to HDL but GMP140 was positively related to TC （ P 〈 o. 05, P 〈 o. Ol ）. CONCLUSION Endothelial functions are damaged in patients with essential hypertension. The indexes of endothelial function are related to the systolic blood pressure, blood glucose and lipid. Losartan can improve the vascular endothelial functions in patients with essential hypertension.