替米沙坦减少高血压合并2型糖尿病患者炎症细胞因子和内皮素

Telmisartan Decreases the Inflammatory Cytokines and Endothelin in Essential Hypertensive Co-existed with Type 2 Diabetes Patients

背景文献报道炎症细胞因子和内皮素在原发性高血压(EH)发病中起到重要作用,参与EH病变的发生发展过程。目的探讨替米沙坦对高血压合并2型糖尿病患者血浆炎症细胞因子和内皮素的影响。方法高血压合并2型糖尿患者76例随机分为常规组(n=38)和实验组(n=38),实验组在常规组用药基础上,加服替米沙坦80mg/d,两组均治疗10周。同时选择健康成人38例作为对照组。检测常规组和实验组治疗前后血糖、血清炎症细胞因子和内皮素水平,观察血压变化。结果治疗10周实验组和常规组血压、血糖均下降(P<0.05),两组差异无统计学意义(P>0.05);实验组血浆肿瘤坏死因子α(TNF-α)、白介素1(IL-1)、白介素6(IL-6)和内皮素1(ET-1)显著下降[TNF-α:治疗前(32.6±4.6)比治疗后(25.9±3.8)ng/L,P<0.05;IL-1:治疗前(87.6±8.2)比治疗后(54.3±7.6)ng/L,P<0.05;IL-6:治疗前(112.1±10.3)比治疗后(77.2±8.4)ng/L,P<0.05;ET-1:治疗前(54.6±5.7)比治疗后(34.3±5.2)ng/L,P<0.05],常规组血浆TNF-α、IL-1、IL-6和ET-1减少不明显(P>0.05)。结论替米沙坦可降低高血压合并2型糖尿病患者血浆炎症细胞因子和内皮素,改善血管内皮功能,抑制炎症反应。

Background It has been reported that the inflammatory cytokines and endothelin play important roles in the developement of essential hypertension. Objective To investigate the effects of telmisartan on the inflammatory cytokines and endothelin in essential hypertensive co-existed with type 2 diabetes patients. Methods Seventy-six cases of essential hypertensive co-existed with type 2 diabetes patients were recruited, and randomized to receive conventional treatment （n=38） or telmisartan （80 mg/d） on the basis of conventional treatment （n=38） for 10 weeks. Thirty-eight healthy persons were chosen as control group. The levels of inflammatory cytokines and endothelin of each group before and after treatment were determined. Results The blood glucose and blood pressure of telmisartan group and conventional group were all decreased （ P〈0.05）, without intergroup differences（ P〉0.05 ）. The plasma TNF-α, IL -1, IL-6 and ET-1 of telmisartan group had obviously decreased after treatment[TNF-α, before： （32.6±4.6） vs after： （25.9±3.8）ng/L, P〈0.051 IL-1, before： （87.6±8.2） vs after：（54. 3±7. 6）ng/L, P〈0.05;IL-6： （112.1±10.3） vs after： （77.2 ±8.4） ng/L, P〈0.05; ET-1, before：（54.6±5.7） vs after： （34.3±5.2）ng/L, P〈0.05], while little changes in plasma TNF-α, IL-1, IL-6 and ET-1 of conventional group were found. Conclusion Telmisartan can decrease inflammatory cytokines and endothelin in essential hypertensive co-existed with type 2 diabetes patients.