依折麦布对高血压患者肱动脉内皮依赖性扩张功能及尿微量白蛋白的影响

The Effect of Ezetimide on Endothelium Dependent Vasodilation and Microalbuminuria in Patients with Essential Hypertension

目的探讨原发性高血压患者出现轻度血脂异常时,依折麦布对其尿微量白蛋白和肱动脉内皮依赖性扩张功能(以下简称FMD)的治疗效果。方法入选原发性高血压患者80例,随机分为依折麦布组(45例)或非依折麦布组(35例),治疗随防8个月。治疗前及后行血脂水平、肱动脉内皮依赖性扩张功能(FMD)和尿白蛋白/肌酐等检查。结果从表2看出,以上两组病人基线情况相似。依折麦布组接受依折麦布治疗时间约8个月,检查显示指标均显著下降(P<0.01),包括:总胆固醇、LDL胆固醇、尿白蛋白及肌酐;非依折麦布组患者后负荷后1h的FMD明显低于依折麦布组(P<0.05),且依折麦布组后负荷后1h的FMD升高最显著(P<0.01);依折麦布组和非依折麦布组负荷后4h FMD升高程度比较,组间差异显著(P<0.05),有统计学意义,依折麦布组高于非依折麦布组。结论原发性高血压患者在接受常规降压药物治疗基础上,采用依折麦布改善轻度血脂异常的效果较好,可有效提升肱动脉内皮依赖性扩张功能,并稳定或逆转动脉粥样硬化的进展。

Objective To explore the effect of ezetimide on endothelium dependent flow-mediated vasodilation （FMD） and microalbuminuria in patients essential hypertension.Methods A total of 80 essential hypertensive patients,were randomisedly assigned to conventional anti-hypertensive drugs plus ezetimide group （ezetimide group,n=45） and conventional anti-hypertensive drugs group （con- ventional group,n=35）. All the patients were treated and followed up for 8 months. The changes of cholesterol, the levels of mieroalbuminuriaand FMD between baseline and the end of 8 monthes were analysed.Results At the end of 8 months, ezetimide group showed more significantly reduc- tion in total cholesterol, LDL-C and the levels of microalbuminuria. After 8 month of ezetimide therapy.FMD at 1 hour was significantly higher than that in conventional anti-hypertensive drugs alone and FMD at 4 hours was also significantly higher than that in conventional anii-hyperten- sire drugs alone. Conclusions Ezetimide therapy on the basis of conventional anti-hypertensive drugs treatment yielded better results in the context of improving endothelium dependent flow-me- diated vasodilation （FMD） and showed favorable effects on arteriosclerosis in hypertensive patients with mild elevation of LDL-C.