缬沙坦对高血压患者粥样硬化动脉形态及功能的影响

The clinical effects of. valsartan on structure and function of atherosclerotic artery in hypertensive Patients

目的观察缬沙坦对原发性高血压患者粥样硬化动脉形态及功能的影响。方法以彩色多普勒超声检测89例原发性高血压患者颈动脉内膜-中层厚度（IMT），并按照IMT值将89例患者分为三组（A、B、C组），连续服用缬沙坦36个月后检测颈动脉IMT和未受干预状态下、肱动脉反应性充血时以及含服硝酸甘油后颈动脉内径，与治疗前进行比较。结果使用缬沙坦8周后血压能控制在140／90mmHg以下且保持平稳。治疗前A、B、C三组的颈动脉IMT值分别为（1．04±0．06）、（1．23±0．04）、（1．33±0．05）mm，治疗36个月后，三组的颈动脉IMT值分别为（0．95±0．03）、（1．08±0．10）、（1．19±0．19）mm，各组治疗前后比较，均P〈0．01．A组IMT值恢复达正常，B组IMT值接近正常。A、B、C三组治疗前肱动脉反应性充血时颈动脉内径的变化率分别为（6．9±2．3）％、（6．1±2．1）％、（5．9±1．2）％，治疗后分别为（24.7±7．0）％、（20．6±4．7）％、（14．3±3．8）％，各组治疗前后比较，均P〈0．01，A组疗效优于B组（P〈0．05）、C组（P〈0．01），B组疗效优于C组（P〈0．01），含服硝酸甘油后颈动脉内径在治疗前后无显著变化。结论缬沙坦在平稳降压的同时，能保护血管内皮细胞，改善血管内皮依赖性舒张功能，延缓甚至逆转IMT的进展。

Objective To evaluate the clinical effects of valsartan on structure and function of atherosclerotic artery in hypertensive patients. Methods The intima-media thickness （IMT） and the inner diameter of carotid artery at rest, to overpressure of brachial artery and after sublingual nitroglycerin administration were measured before and after long-term（36 months） treatment with valsartan by color Doppler ultrasonograms. The hypertensive patients（89 cases） were divided into 3 groups according to the value of IMT. Results The blood pressure was controlled to therapeutic aim and maintained stable after 8 weeks treatment with valsartan. The carotid artery IMT of hypertensive patients was lowered significantly and the endothelium-dependent vasodilative function of common carotid artery was improved dramatically after 36 months therapy with valsartan. The IMT and endothelium-dependent vasodilafive function came up to normal standards in group A and approached the normal level in group B. Conclusion Valsartan can improve the endothelium-dependent vasodilative function, retard or even reverse the progression of carotid artery IMT, while lowering blood pressure stably.