卡托普利对高血压病患者内皮功能和非对称二甲基精氨酸的影响

Effect of Captopril on Endothelium-dependent Vasodilatation Function and Serum ADMA in Essential Hypertension

目的观察高血压病患者服用卡托普利后肱动脉内皮功能和血浆ADMA的变化。方法入选35例高血压病患者口服卡托普利25mg3次/d,随访3月(高血压组),同时选择32例健康成人作为对照组,观察对照组和高血压病患者治疗前后肱动脉基础内径、充血后内径的变化以及采用HPLC法检测血浆非对称二甲基精氨酸(ADMA)的变化,并观察患者血压变化和药物的不良反应。结果高血压病患者血压较对照组明显升高(P<0.05)。同对照组相比,高血压病患者肱动脉血流介导的血管舒张功能(FDM)显著降低(5.84±4.72vs12.7±3.47%,P<0.05),血浆ADMA水平显著增加(0.87±0.35vs0.58±0.36μmol/L,P<0.05)。经卡托普利治疗3月后,高血压病患者的血压下降,肱动脉FDM好转(9.75±3.28vs5.84±4.72%,P<0.01),血浆ADMA水平降低(0.65±0.31vs0.87±0.35μmol/L,P<0.01)。结论卡托普利不仅可降低高血压病患者血压,同时可显著改善患者的内皮功能。

Objective To investigate the effect of captopril on blood pressure, the brachial artery endothelial function and serum asymmetric dimethylarginine （ADMA） in hypertensive patients. Methods A total of 35 patients with essential hypertension and 32 healthy subjects were enrolled in this study. Right brachial artery dilatation induced by reactive hyperemia was performed and ADMA was detected by HPLC in all individuals before and after treated with captopril for 3 months. Resuits The blood pressure in hypertensive patients was significantly higher than that in healthy subjects （P〈 0.05）. As compared with healthy subjects, the flowmediated vasodilation （FDM） of brachial artery was significantly lower in hypertensive patients （5.84 ± 4.72 vs. 12.7 ± 3.47%, P〈0.05）, while the serum ADMA level was significantly increased （0.87 ± 0.35 vs. 0.58 ± 0.36 μmol/L, P〈0.05）. However, FDM reversed and serum ADMA level decreased after treating with captopril for 3 months in hypertensive patients （9.75±3.28 vs. 5.84±4.72%, P〈0.01; 0.65±0.31 vs. 0.87±0.35 μmol/L, P〈 0.01）. Conclusions Captopril can not only reduce blood pressure but also improve the endothelium- dependent vasodilatation function in hypertensive patients.