奥利司他对肥胖高血压患者非内皮依赖性血管舒张功能的影响

Effects of orlistat on endothelium-independent vasodilation function in obese subjects with hypertension

目的:观察肥胖高血压患者服用奥利司他治疗前后血压和硝酸甘油介导的肱动脉非内皮依赖性血管舒张功能的变化。方法:30例肥胖合并轻度高血压患者(肥胖高血压组)奥利司他120 mg,3次/d,共12周,服药前后诊所测量身高、体重、腰围及血压,计算BMI。并行肱动脉高解像度超声检查,舌下含服硝酸甘油0.3 mg,测定硝酸甘油介导的血管舒张(NMD)程度的变化。15例非肥胖的高血压患者作为对照组。结果:两组基线的特征具有可比性。肥胖高血压组患者治疗前与非肥胖高血压患者的NMD无差别,但BMI及腰围明显增加(P均<0.01)。奥利司他治疗12周后BMI、腰围、血压均有显著下降(P<0.05或P<0.01);NMD较治疗前无明显改善(16.2%vs15.5%,P>0.05)。结论:奥利司他短期治疗能降低肥胖高血压患者的体重及血压,但对硝酸甘油介导的肱动脉非内皮依赖性血管舒张功能无作用。

AIM： To evaluate the effect of orlistat on blood pressure and arteria brachialis nitroglycerin mediated endothelium-independent vasodilation in obese subjects with hypertension.METHODS： Thirty obese patients with mild hypertension（obese hypertension group） took orlistat 120 mg tid for 12 weeks.The height,body weight,waist circumference（WC） and blood pressure were measured and the body mass index（BMI） was calculated.The degree of nitroglycerin-mediated vasodilation（NMD） of brachial artery was determined by high-resolution ultrasound before and after 12 weeks treatment with orlistat.15 concurrent blood pressure,age and gender-matched non-obese hypertensive patients served as control.RESULTS： The baseline parameters were comparable between the two groups.There were no differences in NMD between obese hypertension group and no obese hypertension group before treatment,while the BMI and WC were obviously increased in obese hypertension group（P〈0.01,respectively）.The BMI,WC and blood pressure were decreased significantly（P〈0.05 or P〈0.01,respectively） after 12 weeks orlistat treatment.Compared with that in before treatment group the NMD was not significantly affected（16.2% vs 15.5%,P〉0.05）.CONCLUSION： Orlistat can decrease the body weight and blood pressure in a short period treatment,but there were no effects on arteria brachialis nitroglycerin-mediated endothelium-independent vasodilation in obese hypertension patients.