培哚普利对高血压炎症及大动脉弹性的影响

Effect of Perindopril on Cytokine Levels and Large Artery Elasticity in Patients with New-Onset Hypertension

目的评价不同剂量培哚普利对炎症因子及大动脉弹性的影响。方法门诊选取初发高血压患者100例,排除继发性可能后,服药前测定基础状态下的血压、细胞因子及脉搏波速度,给予培哚普利4 mg,1次/d,3周后动态血压选取平均血压SBP≥130 mm Hg或DBP≥80 mm Hg的患者60例,随机分成两组,对照组给予培哚普利4 mg+氢氯噻嗪12.5 mg,1次/d;治疗组给予培哚普利8 mg,1次/d。随访12周,再次测定两组的血压、炎症因子及脉搏波速度。结果两组血压及其它项目入选时测定差异无统计学意义,具有可比性,分组服药随访12周后两组血压均有下降,但无显著性差异,4 mg与8 mg组分别为[SBP(135.2±5.5)mm Hg vs(134.7±6.3)mm Hg,P>0.05;DBP(83.4±7.5)mm Hg vs(82.8±6.5)mm Hg,P>0.05],脉搏波速度、IL-6两组均有下降,且两组比较差异有统计学意义,4 mg与8 mg组分别为[PWV(12.2±2.4)m/s vs(9.1±2.7)m/s,P<0.05);IL-6(167.4±21.3)pg/L vs(122.7±18.9)pg/L,P<0.05],IL-10两组均有上升,4 mg与8 mg组分别为(130.6±23.6)pg/L vs(148.5±19.9)pg/L,P<0.05。结论培哚普利除有效控制血压外,能进一步改善中央弹力动脉的顺应性,改善高血压时的炎症因子失衡,呈剂量依赖,且改善作用不依赖于降压作用。

Objective To evaluate the effect of different doses of perindopril on inflammatory cytokines levels and large arterial elasticity in patients with new-onset hypertension. Methods Total 100 patients with new-onset hypertension were selected, the blood pressure, interleukin-6 （ IL-6）, interleukin-10 （IL-10） and pulse wave velocity （PWV） were assayed. Then all patients were given perindopril 4mg orally every day for 3 weeks. 60 patients which average SBP was greater than or equal to 130 mm Hg or average DBP was greater than or equal to 80 mm Hg by ambulatory blood pressure（ABP） were randomly divided into control group（ perindopril 4 mg plus hydrochlorothiazide 12.5 mg） and observation group（ perindopril 8 mg）. The indexes above were measured again after 12 weeks treatment. Restdts There were no difference in blood pressure,IL-6,IL-10 and PWV before the treatment. After the treatment of 12 weeks, the blood pressure was decreased in both group, but there was no significant differ- ence ： SBP was （ 135.2± 5.5 ）mm Hg in the control group and （ 134.7± 6.3 ） mm Hg in the observation group, P 〉 0. 05 ; DBP was （ 83.4 ± 7.5 ） mm Hg in the control group and （ 82.8 ± 6.5 ） mm Hg in the observation group, P 〉 0. 05. PWV and IL-6 decreased after the treatment ：PWV was （12.2 ± 2.4）m/s in the control group and （9.1± 2.7 ）m/s in the observation group,P 〈 0.05 ） ;IL-6 was （167.4 ±21.3 ）pg/L in the control group and （122.7 ± 18.9 ）pg/L in the observation group ,P 〈 0.05. IL-10 increased in both groups after the treatment,IL-10 was （ 130.6±23.6） pg/L in the control group and （ 148.5 ±19.9） pg/L in the observation group,P 〈 0.05. Conclusion Perindopril has a good effect on BP control, in addition, it can improve the elasticity of central elastic artery, correct the imbalance of inflammatory cytokines, and this effect is not dependent on BP decrease but is dose-depend.