缬沙坦对高血压合并糖耐量异常患者一氧化氮和炎症因子影响

Effects of valsartan on levels of nitric oxide and inflammatory factors in patients with hypertension accompanied with impaired glucose tolerance

目的:观察血管紧张素Ⅱ受体拮抗剂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)及血浆炎症因子水平的影响。方法:36例原发性高血压合并糖耐量异常患者口服缬沙坦80 mg,1次/d。选择36例正常人作为正常对照组。检测治疗前后血压、空腹血糖、餐后2 h血糖(2hPG)、胰岛素抵抗指数(HOMA-IR)、血浆炎症因子和一氧化氮水平变化。结果:与治疗前比较,高血压合并糖耐量异常患者口服缬沙坦治疗8周末血压[(163.95±8.0)/(99.10±11.8)mmHg:(132.93±10.7)/(82.14±9.5)mmHg]、2hPG[(9.10±1.10)mmol/L∶(7.85±1.15)mmol/L]和HOMA-IR[(3.90±2.11)∶(2.73±1.71)]明显下降,P均<0.01。与治疗前比较,治疗后血浆TNF-α和IL-6水平显著下降,血浆NO水平显著上升(P均<0.01)。结论:缬沙坦可降低高血压合并糖耐量异常患者血浆炎症因子水平,升高一氧化氮水平,改善血管内皮舒张功能及胰岛素抵抗,和抑制炎症反应。

Objective：To observe effects of angiotensin Ⅱ receptor blocker——valsartan on plasma levels of nitric oxide（NO） and inflammatory factors in patients with essential hypertension（EH） accompanied with impaired glucose tolerance（IGT）.Methods： A total of 36 patients with EH accompanied with IGT received valsartan（80 mg,1 time/d） oral.Another 36 healthy people were chosen as normal control group.Changes of levels of blood pressure,fasting blood glucose,2h postprandial blood glucose（2hPG）,homeostasis model-insulin resistance index（HOMA-IR）,plasma inflammatory factors and NO were measured before and after treatment.Results：Compared with before treatment,there were significant decrease in levels of blood pressure[（163.95±8.0）/（99.10±11.8）mmHg vs.（132.93±10.7）/（82.14±9.5）mmHg],2hPG [（9.10±1.10） mmol/L vs.（7.85±1.15） mmol/L]and HOMA-IR[（3.90±2.11） vs.（2.73±1.71）],P0.01 all in EH patients accompanied with IGT on eight weeks after treatment with valsartan.Compared with before treatment,the levels of plasma TNF-α and IL-6 significantly decreased,and the level of plasma NO significantly increased after treatment,P0.01 all.Conclusion：Valsartan can decrease levels of plasma inflammatory factors and increase level of nitric oxide,improve insulin resistance and vascular endothelial diastolic function and inhibit inflammatory reactions.