高血压患者氯沙坦治疗前后血管内皮功能与血管紧张素Ⅱ的变化

Variation of the endothelium-dependent relaxing function of brachial artery and the plasma angiotensin Ⅱ in hypertensive patients before and after the treatment with losartan

目的 探讨氯沙坦治疗前后高血压患者血管内皮功能和血浆血管紧张素Ⅱ的变化。 方法 5 0例高血压患者氯沙坦治疗 4～ 6周 ,根据达目标血压 (以舒张压 <90mmHg为标准调整降压药每天剂量 5 0～ 10 0mg ,部分患者加双氢氯噻嗪 2 5mg) ,观察氯沙坦治疗前后肱动脉超声检测血管内皮功能和血浆血管紧张素Ⅱ浓度的变化。 结果 肱动脉内径基础值及含服硝酸甘油后肱动脉内径变化差异均无显著性〔(3 78± 0 5 7)mm对 (3 82± 0 6 3)mm ,(18 7± 4 5 ) %对 (2 0 1± 7 2 ) % ,P >0 0 5〕 ,反应性血管充血引起肱动脉内径的变化治疗前后差异有显著性〔(4 32± 0 71) %对(9 38± 4 1) % ,P <0 0 1)〕。氯沙坦治疗前后血浆血管紧张素Ⅱ浓度变化显著〔(38 6± 6 8)pmol/L对 (76 9± 15 3)pmol/L ,P <0 0 1〕。 结论 氯沙坦在有效降压的同时 ,能改善血管内皮舒张功能。

Objective To study the effect of hypertension management with losartan on the endothelium dependent relaxing function and the plasma level of angiotension Ⅱ. Methods Fifty patients with hypertension were treated with losartan (50 mg, 100 mg, and 100 mg + hydrochlorothiazide 25 mg/day, according to the status of blood pressure). Endothelium dependent relaxing function was measured with high resolution ultrasound and the plasma level of angiotension Ⅱ was determined. Results There were no significant difference in baseline and response to nitroglycerin before and after treatment of losartan 〔(3 78±0 57)mm vs (3 82±0 63)mm, (18 7±4 5)% vs (20 1±7 2)%, P >0 05〕 but were significant difference in responsive congestion of the brachial artery between before and after treatment 〔(4 32±0 71)% vs (9 38±4 1)%, P <0 01〕. The plama levels of angiotension Ⅱ after treatment〔(38 6±6 8)pmol/L vs (76 9±15 3)pmol/L, P <0 01〕 was increased significantly. Conclusions Hypertension management with losartan improves endothlium dependent vasodiliation.