拉西地平对原发性高血压患者颈动脉内膜-中膜厚度和超敏C反应蛋白的影响

Effects of Lacidipine on Carotid Artery IMT and Hs-CRP in Primary Hypertensive Patients

目的观察拉西地平对原发性高血压(PH)患者颈动脉内膜-中膜厚度(IMT)和超敏C反应蛋白(hs-CRP)的影响。方法 43例患者给予拉西地平片(司乐平)治疗24周,观察治疗前、后血压变化,于治疗前、后应用彩色多普勒超声诊断仪行双侧颈动脉超声检查,观察血管形态、结构,内膜是否光滑,有无增厚及粥样斑块形成;采用免疫透射散射浊度法测定血清hs-CRP水平,并与同期30名健康体检者进行对照。结果患者IMT明显增加,血清hs-CRP水平显著增高,与健康对照组比较,差异有统计学意义(P<0.01)。拉西地平治疗后患者血压显著改善(P<0.01),临床总有效率为90.70%;IMT明显变薄、血浆hs-CRP水平明显下降,与治疗前比较,差异有统计学意义(P<0.01)。结论拉西地平降压疗效确切,耐受性好,具有抗动脉粥样硬化和血管内皮保护作用,可能逆转血管重构,延缓动脉粥样硬化的进展。

Objective To observe the effects of lacidipine on carotid artery intima-media thickness（IMT） and high sensitivity C reactive protein（hs-CRP） in primary hypertensive（PH） patients.Methods Forty-three cases of PH patients were given lacidipine for 24 weeks.The blood pressure（BP） changes before and after treatment were observed.Before and after treatment,the color Doppler ultrasonic diagnostic apparatus was adopted to detect bilateral carotid arteries for observing the vascular morphology,structure,intimal smooth,thickening and plaque formation.The immune transmission scattering turbidity method was used to detect for the serum level of hs-CRP,and the detection results were compared with those in 30 healthy controls at the same period.Results IMT in the PH patients was significantly thickened and the serum level of hs-CRP was increased significantly,which showed statistical difference compared with the normal control group（P〈0.01）.BP after treatment in the PH patients was significantly improved（P〈0.01）,with the total clinical effective rate of 90.70%;IMT was significantly thin,the plasma level of hs-CRP was significantly decreased,with statistical difference compared with before treatment（P〈0.01）.Conclusion Lacidipine has definite antihypertensive efficacy,good tolerance,anti-atherosclerosis（AS） and vascular endothelial protective effects,may reverse vascular remodeling and slow the progression of AS.