不同降压方案对老年原发性高血压患者内皮功能的影响

Effect of Different Antihypertensive Therapies on Endothelial Function in Senile Patients with Primary Hypertension

目的探讨不同降压方案对老年原发性高血压患者内皮功能的影响。方法将2009年3月至2012年10月来我院就诊的146例老年原发性高血压患者随机均分为观察组和对照组,其中观察组患者采取替米沙坦联合氨氯地平治疗,对照组患者单用氨氯地平,比较两组患者治疗前后的血压及内皮功能改善情况。结果两组患者经治疗舒张压与收缩压均较治疗前有明显下降(P<0.01),但观察组下降更明显(P<0.01);治疗后观察组NO水平明显上升,ET-1、vWF水平明显下降,血管内皮功能较治疗前明显改善(P<0.01);治疗后对照组ET-1无明显下降,但NO、vWF均明显改善(P<0.01),但观察组改善更明显(P<0.01)。结论替米沙坦联合氨氯地平治疗老年原发性高血压效果显著,能明显控制患者的血压,改善受损的内皮功能,值得临床推广应用。

Objective To investigate the effect of antihypertensive therapy on endothelial function in senile patients with primary hypertension. Methods 146 patients with primary hypertension were randomly divided into two groups, the observation group adopted combination of telmisartan and amlodipine treatment, the control group was treated with amlodipine. The blood pressure and improved situation of endothelial function before and after treatment were compared between the two groups. Results The diastolic and systolic blood pressure of the two groups after treatment decreased significantly （P〈0.01）, and it was more evident in the observation group （P 〈0.01）. The NO level in the observation group increased significantly, the ET-1, vWF decreased significantly, and the vascular endothelial function significantly improved after treatment （P 〈0.01）. The ET-1 in the control group had no obvious decrease, NO, vWF were significantly improved （P〈0.01）, but the observation group improved more obviously （P〈0.01）. Conclusions The combined treatment of telmisartan and amlodipine for elderly patients with primary hypertension can significantly control the blood pressure and improve endothelial function with significant effect, which is worthy of clinical application.