厄贝沙坦氢氯噻嗪片对老年高血压患者血管内皮功能的短期影响

Short-term effects of Irbesartan Hydrochlorothiazide tablets on vascular endothelial function in elderly patients with hypertension

目的 评价厄贝沙坦氢氯噻嗪片对老年高血压患者血管内皮功能的短期影响.方法 选择轻、中度原发性高血压患者106例,分为氢氯噻嗪组50例及厄贝沙坦氢氯噻嗪组56例,两组患者每日晨起分别口服氢氯噻嗪片25 mg及厄贝沙坦氢氯噻嗪片1片,连续12周,检测治疗前后患者的血压、血生化、高敏C反应蛋白（hs-CRP）、血管性血友病因子（vWF）等指标,以及肱动脉内皮依赖性舒张功能（EDD）和颈动脉内膜中层厚度（IMT）的变化.结果 与治疗前比较,氢氯噻嗪组患者治疗后收缩压、舒张压、血钾明显降低（P ＜0.05或P＜0.01）,尿酸明显升高（P＜0.01）,治疗前后vWF、EDD、IMT比较差异无统计学意义（P＞0.05）；厄贝沙坦氢氯噻嗪组患者治疗后收缩压、舒张压、hs-CRP及vWF均明显降低（P＜0.05或P＜0.01）,EDD明显提高（P＜0.05）,治疗前后IMT比较差异无统计学意义（P＞0.05）.两组患者治疗后比较,vWF、EDD比较差异有统计学意义（P＜0.05）.结论 老年轻、中度原发性高血压患者的血管内皮功能的损伤可以逆转,厄贝沙坦氢氯噻嗪片在降压同时可以改善受损的血管内皮功能.

Objective To evaluate short-term effects of Irbesartan Hydrochlorothiazide tablets on vascular endothelial function in elderly patients with hypertension.Methods 106 patients of mild to moderate essential hypertension were divided into group of Irbesartan hydrochlorothiazide and group of hydrochlorothiazide.The former received hydrochlorothiazide one tablet and the latter received Irbesartan Hydrochlorothiazide one tablet in the morning for 12 weeks.At the beginning and end,all patients were observed their blood pressure,blood biochemistry,high-sensitivity C-reactive protein （hs-CRP）,yon Willebrand Factor（vWF） and brachial artery endothelium-dependent dilation（EDD） as well as carotid intima-media thickness（IMT）.Results Systolic blood pressure and diastolic blood pressure of two groups were decreased （P ＜ 0.01）.Compared with group of hydrochlorothiazide,levels of vWF were all reduced and EDD improved significantly after treatment in group of Irbesartan hydrochlorothiazide（P ＜ 0.05）.There were no differences of IMT in two groups （P ＞ 0.05）.After treatment,there are significantly differences of vWF and EDD between the groups （P ＜ 0.05）.Conclusions Damage of vascular EDD in patients with mild to moderate essential hypertension is reversible.Irbesartan hydrochlorothiazide tablets have antihypertensive effect and may improve vascular endothelial function.