伊贝沙坦对原发性高血压患者血浆内皮素及循环内皮细胞的影响

The Effects of Irbesartan on The Vascular Endothelial Function in Essential Hypertensive Patients

目的 观察血管紧张素Ⅱ受体拮抗剂伊贝沙坦治疗原发性高血压患者对血浆内皮素1（ET-1）及循环内皮细胞（CECs）的影响。方法 入选50例1～2级原发性高血压患者，经2周安慰剂洗脱期后，给予伊贝沙坦150mg／d，治疗4周，如血压得到控制（收缩压〈140mmHg和舒张压〈90mmHg），继续原剂量治疗4周；如血压未得到控制[收缩压≥140mmHg和（或）舒张压≥90mmHg]，将药物剂量加倍继续治疗4周，观察血浆ET-1、CECs及血压的变化。结果 50例患者均完成试验，口服伊贝沙坦2周末血压明显下降[治疗前：（154．0±12．8／96．3±2．0）mm Hg vs治疗后（130．4±10．8／84．5±9．5）mmHg，P〈0．01]，治疗2、4、6、8周末血压间无明显差异；与治疗前比较，治疗后血浆ET-1和CECs显著下降[ET-1：治疗前（37．5±9．5）vs治疗后（29．7±12．1）ng／L．P〈0．01；CECs：治疗前（6．7±3．6）vs治疗后（4．4±2．8）10^6cells／L，P〈0．01]。结论 对于轻中度原发性高血压患者，伊贝沙坦有效降压的同时改善血管内皮功能。

Objective To study the effects of Irbesartan on plasma endothelin-1 （ET-1） and circulating endothelial cells （CECs） in the patients with essential hypertension. Methods After a period of 2 week singleblind placebo wash-out, mild-to-moderate essential hypertensive patients （n = 50） were treated with Irbesartan 150 mg once daily for 4 weeks, and titrated to 300 mg/d for another 4 weeks in patients whose seated DBP sustained≥ 90 mm Hg or SBP≥140 mm Hg. The plasma levels of endothelin-1, CECs and blood pressure were measured before and after 8 week treatment. Rusults Irbesartan significantly decreased BP [before 154.0±12.8/96.3± 2.0 vs after 130. 4±10. 8/84.5±9.5 mm Hg （P〈0. 01）] associated with reduction in the plasma levels of ET-1 and CECs （ET-1, before 37.5 ± 9.5 vs after 29. 7 ± 12.1 ng/L, P〈0.01; CECs, before 6.7±3.6 vs after 4.4 ± 2. 8 10^6 cells/L, P〈0.01）. Conclusion Irbesartan decrease blood pressure and improve the function of the vascular endothelium in patients with essential hypertension.