缬沙坦对高血压患者餐后血浆炎症因子的影响

Effect of valsartan on postprandial plasma inflammatory factors in patients with essential hypertension

目的:探讨极短期缬沙坦治疗在控制血压的同时,是否影响高血压患者餐后血浆高敏C-反应蛋白(high sensitivity CRP,hsCRP)和可溶性P选择素浓度。方法:高血压患者(n=50)被随机分为两组,分别接受拉西地平4 mg/d(拉西地平组,n=25)和缬沙坦80 mg/d(缬沙坦组,n=25)。高血压患者和健康人(n=25)在禁食12 h后接受高脂餐,检测空腹和餐后4 h血浆hsCRP,可溶性P选择素和血脂水平。1周后,再次进行高脂餐负荷试验并检测上述指标。结果:高血压患者餐后与餐前相比较,血浆甘油三酯(TG)、hsCRP和P选择素浓度显著升高(P<0.05)。健康人餐后血浆hsCRP和P选择素浓度无显著变化;餐后血浆TG浓度显著升高(P<0.05),但低于高血压患者(P<0.01)。餐后TG浓度增长值与餐后log(hsCRP)增长值、血浆可溶性P选择素浓度增长值显著相关(n=75,r分别0.344和0.432,P<0.01)。1周后,两组高血压患者的空腹和餐后血脂浓度较基础水平无显著变化。1周后缬沙坦组餐后血浆hsCRP和P选择素浓度较空腹水平差异无统计学意义(P>0.05);拉西地平组餐后血浆hsCRP和P选择素浓度较空腹水平仍有显著升高(P<0.05)。结论:一次性高脂餐可导致高血压患者出现餐后炎症反应,缬沙坦可在短期内减轻这种餐后炎症反应。

Objective To explore the effect of valsartan on the concentrations of plasma inflammatory factors after a high-fat meal in patients with essential hypertension in very short time. Methods Fifty hypertensive patients and 25 healthy controls were studied. Patients randomly accepted lacidipine 4 mg/d （lacidipine group） or valsartan 80 mg/d （valsartan group） for 1 week. The concentrations of plasma lipid profiles, high-sensitivity C-reactive protein （hsCRP） and soluble P- selectin were measured in fasting state and at 4 h after a single high-fat meal in all subjects at baseline and in patients after 1 week. Results The concentrations of postprandial plasma hsCRP and soluble P-selectin significantly increased after a high-fat meal in patients （ P 〈 0.05 ） , as compared with those at fasting levels, but not in the controls. The postprandial plasma triglyceride concentrations significantly increased in the healthy controls （ P 〈 0.05 ） , but were lower than those in hypertensive patients （ P 〈 0.01 ）. Postprandial change in plasma concentration of triglyceride was significantly correlated with those of log（hsCRP） （r =0. 344）and soluble P-selectin （r = 0. 432）, respectively （ n = 75, both P 〈 0.01 ）. Lipids profiles did not change significantly after 1 week. There was no significant difference between the fasting and postprandial plasma concentrations of either hsCRP or soluble P-selectin in valsartan group, while the postprandial increments of inflammatory factors were still significant in the lacidipine group. Conclusion High-fat meal can induce postprandial inflammation response in patients with essential hypertension. Valsartan effectively attenuates this postprandial inflammation response within a very short time.