缬沙坦对原发性高血压合并糖耐量异常患者血管内皮功能的影响

Effects of valsartan on endothelial function in essential hypertension with impaired glucose tolerance

目的观察缬沙坦对原发性高血压合并糖耐量异常患者血浆一氧化氮(NO)以及氧化应激的影响。方法 42例原发性高血压合并糖耐量异常患者口服缬沙坦80 mg,每日1次。选择40例正常人作为对照组。检测治疗前后血糖、餐后2小时血糖(2 hPG)、胰岛素抵抗指数(HOMA-IR)、采用硝酸还原法测定血清NO,采用生化法测定血浆中超氧化物歧化酶(SOD),谷胱甘肽过氧化物酶(GSH-PX)和丙二醛(MDA)的含量。结果 42例患者均完成试验,口服缬沙坦治疗8周末与对照组比较,患者组治疗前后比较2 hPG、HOMA-IR和血压明显下降,2 hPG治疗前(9.10±1.10)mmol/L vs治疗后(7.85±1.15)mmol/L(P<0.01);HOMA-IR治疗前3.90±2.11 vs治疗后2.73±1.71(P<0.01)。治疗前血压(160.71±13.10/99.10±11.78)mmHg(1 mmHg=0.133 kPa)vs治疗后(132.93±10.7/82.14±9.5)mmHg(P<0.01);与治疗前比较,治疗后血浆MDA显著下降,治疗前MDA(22.98±1.93)μmol/L vs治疗后(19.70±1.09)μmol/L(P<0.01)、与治疗前比较,患者组治疗后血浆GSH-PX、SOD和NO显著上升,GSH-PX治疗前(0.16±0.04)μmol/L vs治疗后(0.18±0.03)μmol/L(P<0.05);治疗前SOD(55.06±7.23)mU/L vs治疗后(63.07±6.78)mU/L(P<0.01);治疗前NO(38.10±7.36)μmol/L vs治疗后(43.38±7.52)μmol/L(P<0.01)。结论缬沙坦可改善高血压合并糖耐量异常患者血管内皮功能,减少氧化应激。

Objective To study the effects of valsartan on NO and peroxidation in essential hypertension（EH） with impaired glucose tolerance（IGT）.Methods Forty-two patients of EH with IGT received valsartan（80 mg/d） orally once a day for eight weeks.Forty health adults served as controls.The levels of fasting blood glucose,postprandial 2 hour blood glucose,homeostasis model assessment index（HOMA-IR）,serum nitric oxide（NO）,glutathione peroxidase（GSH-PX）,superoxide dismutase（SOD） and malonyldialdehyde（MDA） before and after treatment were measured.Results All 42 patients finished the therapy course.After oral treatment of valsartan for eight weeks,2 hPG,HOMA-IR,blood pressure and MDA in the patients group showed significantly more decrease compared with those of controls.The indexes in the patients group showed significant decrease between pre-and post-treatment,2 hPG（9.10±1.10） mmol/L vs（7.85±1.15） mmol/L（P0.01）,HOMA-IR 3.90±2.11 vs 2.73±1.71（P0.01）,blood pressure（160.71±13.10）/（99.10±11.78） mmHg vs（132.93±10.70）/（82.1±9.50） mmHg（P0.01）,MDA（22.98±1.93） μmol/L vs（19.70±1.09） μmol/L（P0.01）.In the patients group,the plasma GSH-PX,SOD and NO showed significant increase between pre-and post-treatment,GSH-PX（0.16±0.04） μmol/L vs（0.18±0.03） μmol/L（P0.05）,SOD（55.06±7.23） mU/L vs（63.07±6.78） mU/L（P0.01）,NO（38.10±7.36） μmol/L vs（43.38±7.52） μmol/L（P0.01）.Conclusion Valsartan treatment improves endothelial function and decreases the oxidative stress in patients with EH.