有效降血压治疗对老年高血压患者内皮细胞功能和肾血流的影响

The impact on the endothelial cell function and renal blood flow through effective treatment for elderly patients with hypertension

目的探讨有效降血压治疗对老年高血压患者内皮细胞功能和肾血流的影响。方法64例70岁以上、经有效降血压治疗的老年高血压患者按治疗前血压高低分二组：2级高血压组（30例）、3级高血压组（34例），并选择同期健康体检、70岁以上老年人30例为对照组，内皮细胞功能检测通过检测血浆内皮素-1（ET-1）、一氧化氮（NO）、血栓素B2（TXB2）、6-酮-前列腺素F1alpha（6-k—PGF1α）；肾血流检测采用彩色多普勒电脑声像仪检查肾动脉、段动脉、叶间动脉的收缩期最大血流速度（PSV）、舒张末期最低血流速度（EDV）。对2级高血压组、3级高血压组采用有效抗高血压治疗达标1个月，比较三组间ET-1、NO、TXB2、6-k-PGF1α及PSV、EDV差异。结果三组治疗前ET-1、NO、TXB2、6-k—PGF1α、PSV及EDV比较，差异均有统计学意义（均P〈0．05）；治疗血压达标1个月后，三组间各项观察指标比较差异均无统计学无意义（均P〉0．05）。结论老年高血压患者在有效的临床治疗下，内皮细胞功能和肾血流可以得到改善，为有效治疗可延缓老年高血压患者肾损害提供理论依据。

Objective To investigate the impact on the endothelial cell function and renal blood flow through effective treatment for elderly patients with hypertension. Methods 64 cases of elderly hypertensive patients over 70 years old with effective treatment, according to pre-treatment blood pressure ,were divided into two groups ： hyptension level-2 group （30eases） and hypertension level-3 group（34eases） , and 30 eases of elderly people with health physical examination during the same period were setlected as the control group. Endothelial cell function was detected, including the endothelin-1 （ ET-1 ） , nitrous oxide （ NO ） , thromboxane B2 （ TXB2 ）, 6-keto-prostaglandinF1α （ 6-K- PDGF1α） in plasma. Renal blood flow was explored by color doppler ultrasonic instrument,involving peak velocity in systole（ PSV） and lowest velocity in end-diastole （EDV）of renal arteries, segmental arteries and interlobar arteries. After indicators had reached the standard 1 month in the hypertension level-2 and hypertension level-3 patients with effective antihypertensive therapy, the difference of ET-1, NO, TXB2,6-k-PGF1α and PSV, EDV among the three groups were compared. Results The differences were statistically significant in ET-1, NO, TXB2,6-k-PGF1α, PSV and EDV before treatment among three groups （ P 〈 0. 05 ）. After blood pressure treated had reached the standard 1 month, indicators were no statistically meaningful difference among the three groups （ P 〉 0. 05 ）. Conclusion After effective clinical treatments, the endothelial cell function and renal blood flow of the elderly hypertensive patients can be improved. At the same time ,to delay renal damage in elderly patients with hypertension provide a theoretical basis.