西拉普利改善高血压动脉功能的临床研究

Effect of Cliazapril on Large Artery Function in Patients with Essential Hypertension

研究原发性高血压患者上臂动脉功能与血液动力学改变及西拉普利对其逆转效应。方法脉冲多普勒法。结果与血压正常者（ＮＴ）相比，高血压患者（ＨＴ）的前臂阻力（Ｒ）和肱动脉内径（Ｄｄ）增加，平均血流速度（Ｖｍ）减慢，扩张性（ＤＩＳ）和顺应性（ＣＯＭ）减小，但血流量（Ｑ）无差异；在反应性充血状态下，两组的Ｄｄ、Ｖｍ、Ｑ增加，Ｒ减小，但这种变化在ＮＴ更为明显。西拉普利治疗１２周后，ＨＴ的Ｄｄ、Ｖｍ、Ｑ、ＤＩＳ、ＣＯＭ增加，Ｒ减小，但仍与ＮＴ有差异。结论高血压患者早期已有动脉损害，西拉普利可部分逆转这种改变。

Aim\ This study is designed to study the function and hemodynamics of brachial artery and the effect of cilazapril in patients with essential hypertensive(HT).\ Methods\ Pulsed Doppler techniques.\ Results\ Compaired with the normotensives(NT), the HT had an increase in brachial artery inner diameter(Dd) and forearm vascular resistance(R); decreases in mean blood flow velocity(Vm), artery distensibility(DIS) and compliance(COM).\ No difference in the volumic flow(Q) of brachial artery was found.\ Under the condition of reactive hyperemia states,there were an obvious increase in Dd, Vm, Q and decrease in R in both groups,but the changes of these parameters in HT were less significant.\ It was also found that the HT had a lower Q than NT during reactive hyperemia.\ After 12 weeks antihypertensive treatment with cilazapril,the blood pressure,R and Rmin(the resistance in the reactive hypermia states) decreased markedly, the Dd, Vm, Q, DIS and COM increased obviously,but the parameters remained different from the NT.\ Conclusion\ The impairment of large artery occured in the early stage of the development of hypertension, 12 weeks Cilazapril treatment can only partially reverse these changes.