厄贝沙坦及氨氯地平对原发性高血压患者颈-股动脉脉搏传导速度及血清基质金属蛋白酶-9水平的影响

Influence of irbesartan and amlodipine on carotid-femoral artery pulse wave velocity and serum matrix metalloproteinase-9 level in patients with primary hypertension

目的探讨厄贝沙坦及氨氯地平对原发性高血压患者颈-股动脉脉搏传导速度(CFPWV)及血清基质金属蛋白酶-9(MMP-9)水平的影响。方法 38例轻中度原发性高血压患者为高血压组,根据治疗方法分为厄贝沙坦治疗组、氨氯地平治疗组,每组19例。另选择同期来我院健康体检的38例健康个体为对照组。厄贝沙坦治疗组给予厄贝沙坦口服治疗,氨氯地平治疗组给予氨氯地平口服治疗。各组患者均在治疗前后测量收缩压(SBP)、舒张压(DBP);应用法国脉搏传导速度测定仪进行CFPWV测定,以评估大动脉弹性。清晨空腹采集静脉血,离心后采集血清,ELISA法检测血清中MMP-9水平。结果高血压组患者CFPWV、MMP-9水平明显高于对照组(P<0.01);高血压组患者SBP、DBP均明显高于对照组(P<0.01)。厄贝沙坦治疗组、氨氯地平治疗组患者治疗后CFPWV、MMP-9、SBP、DBP水平均较治疗前明显降低(P<0.01)。2组治疗后CFPWV、MMP-9、SBP、DBP水平无显著差异。结论轻中度原发性高血压患者存在动脉结构与功能损害。厄贝沙坦和氨氯地平能有效降低和控制血压,两种药物之间无显著差异。

Objective To explore the influence of irbesartan and amlodipine on carotid- femoral artery pulse wave velocity （CFPWV） and serum matrix metalloproteinase-9 （MMP-9） level in patients with primary hypertension. Methods 38 patients with mild and moderate primary hy- pertension were designed as hypertension group, and they were divided into irbesartan treatment group and amlodipine treatment group, 19 cases in each group. 38 healthy people with physical ex- amination in our hospital were selected and designed as control group. Systolic blood pressure （SBP） and diastolic blood pressure （DBP） were measured before and after treatment in all the groups, and CFPWV was determined with French PWV Tester to evaluate the large arterial elasticity. Fasting venous blood was collected in the morning; serum was separated by centrifugation, and serum MMP -9 level was detected by ELISA. Results Levds of CFPWV, MMP-9, SBP and DBP in hyperten- sion group were higher than those in the control group. After treatment, the levels of CFPWV, MMP-9, SBP and DBP in irbesartan treatment group and amlodipine treatment group decreased significantly（P 〈 0.01 ）, and there were no significant differences of CFPWV, MMP-9, SBP and DBP levels between two groups. Condusion Patients with mild and moderate primary hypertension suffer from arterial structural and functional damages. Irbesartan and amlodipine can effectively reduce and control the blood pressure, and there is no significant difference of efficacy between two drugs