硝苯地平控释片对原发性高血压患者内皮功能的影响

The effect of Adalat on endothelial function of essential hypertensive patients

目的 :研究钙拮抗剂硝苯地平控释片 (商品名 :拜新同 )对原发性高血压 (EH)患者内皮功能的影响。方法 :观察 30例 EH患者 (EH组 )用拜新同治疗前后的血小板聚集功能、抗氧化能力及内皮依赖性舒血管功能等方面的变化 ,并与 10例正常人 (对照组 )对比分析。结果 :1拜新同治疗前 ,EH组血小板最大聚集率、血浆血栓素 B2(Tx B2 )和丙二醛 (MDA )均明显高于对照组 (P <0 .0 5 ) ;血浆超氧化物岐化酶 (SOD)明显降低 (P <0 .0 5 ) ;2拜新同治疗 2个月后 ,EH组血小板最大聚集率 ,Tx B2 及 MDA水平均较治疗前明显降低 (P <0 .0 5 ) ,SOD水平明显升高 (P<0 .0 5 ) ;3拜新同降压总有效率为 83.3% ;4对其中 2 0例 EH患者采用高分辨率超声多普勒检测拜新同治疗前后的肱动脉内径和面积的变化 ,并与对照组比较 ,在口腔喷雾异舒吉 (硝酸盐类制剂即外源性 NO,反映非内皮依赖性的舒血管功能 )后 ,肱动脉内径及面积增加的百分率在两组之间无显著性差异。在血流增加的情况下 (反映内皮依赖性舒血管功能 ) ,EH组肱动脉内径及面积增加的百分率明显低于对照组 (P <0 .0 5 )。拜新同治疗 4个月后则有明显增高 (P <0 .0 5 )。结论 :拜新同在有效降压的同时 ,不仅能抑制血小板聚集 ,增加机体抗氧化能力 。

Objective:To observe the effect of Adalat on endotheliun function of essential hypertensive patients.Method:The platelet aggregation,antioxidation and endothelial dependant vasodilatation and the effect of Adalat intervention were observed in 30 essential hypertensive(EH) patients.Ten healthy subjects were designed as control.Result::①Maxium platelet aggregation rate,contents of plasma TxB 2 and MDA of EH patients were significantly greater than those of the healthy subjects,whereas the contents of SOD of EH patients were significantly less than those of the healthy subjects(P< 0.05 );②Maxium platelet aggregation rate,the contents of TxB 2,MDA of these patients decreased significantly while the contents of SOD increased significantly after two months of Adalat treatment;③The total Adalat effecfive rate of decreasing blood pressure was 83.3 %;④The changes of brachial artery diameter and area of twenty EH patients before and after Adalat treatment were observed with high differentiate ultrasonic imagines.The percentage of flow mediated vasodilation of diameter and area of EH patients was less than those of healthy subjects significantly (P< 0.05 ). After four months of Adalat treatment,the percentage of flow mediated vasodilatation of EH patients was significantly increased (P< 0.05 ).Conclusion:Beside decreasing blood pressure,inhibiting the platelet aggregation and enhancing the antioxidation,Adalat can improve the endothelial function.Adalat possesses a good protective effect on target organs of EH patients.