厄贝沙坦氢氯噻嗪对高血压患者血清CRP、IL-6、Hcy、内皮素水平及血液流变学指标的影响

Influence of irbesartan and hydrochlorothiazide on CRP,IL-6,Hcy and endothelin levels and hemorheology indexes in patients with hypertension

目的探讨厄贝沙坦氢氯噻嗪对高血压患者血清炎性因子[C反应蛋白(CRP)、白细胞介素6(IL-6)]、同型半胱氨酸(Hcy)、内皮素、血液流变学水平的影响。方法 148例原发性高血压患者按照随机分组法分为研究组(n=74)和对照组(n=74)。对照组采用常规对症治疗,研究组在对照组治疗的基础上给予厄贝沙坦氢氯噻嗪治疗。两组总疗程均为3个月。对比分析两组收缩压和舒张压、血清CRP和IL-6、血浆Hcy和内皮素水平、血液流变学指标及进行药物安全性评价。结果两组患者收缩压和舒张压治疗后较治疗前明显下降(P<0.05);研究组收缩压和舒张压治疗后明显低于对照组(P<0.05);研究组血清CRP和IL-6治疗后水平较治疗前明显减少(P<0.05);而对照组血清CRP和IL-6水平治疗前后比较,差异无统计学差异(P>0.05);研究组血清CRP和IL-6治疗后明显低于对照组(P<0.05);研究组血浆Hcy和内皮素治疗后较治疗前水平降低(P<0.05);而对照组血浆Hcy和内皮素水平治疗前后比较,差异无统计学意义(P>0.05);研究组血浆Hcy和内皮素水平治疗后明显低于对照组(P<0.05);两组全血低切黏度、全血高切黏度及血浆黏度治疗前后比较差异均无统计学意义(P>0.05)。结论厄贝沙坦氢氯噻嗪可明显降低高血压患者血压、血清炎症、Hcy、内皮素水平,而对血液流变学指标无影响,未见严重不良反应,安全可靠。

Objective To investigate the influence of irbesartan and hydrochlorothiazide on the serum inflammatory factors（CRP,IL-6）,Hcy,endothelin and hemorheology levels in the patients with hypertension.Methods 148 cases of essential hypertension were divided into the research group（n=74）and the control group（n=74）according to the random grouping method.The control group was treated by the conventionally symptomatic therapy,while on this basis the research group was given with the irbesartan and hydrochlorothiazide therapy.The total treatment course of 2groups were 3months.The systolic pressure and diastolic pressure,serum CRP and IL-6,plasma Hcy,endothelin levels,hemorheology indexes in the two groups were performed the contrastive analysis.The drug safety was evaluated.Results The systolic pressure and diastolic pressure after the treatments in the two groups were significantly decreased compared with before treatment（P〈0.05）;the systolic pressure and diastolic pressure after treatment in the research group were significantly lower than those in the control group（P〈0.05）;the serum CRP and IL-6levels after treatment in the research group were significantly decreased compared with before treatment（P 0.05）;but the serum CRP and IL-6in the control group had no statistically significant difference between before and after treatment（P〉0.05）;the serum CRP and IL-6levels after treatment in the research group were significantly lower than those in the control group（P〈0.05）;the plasma Hcy and endothelin levels after treatment in the research group were significantly decreased compared with before（P〈0.05）;but which in the control group had no statistically significant difference between before and after treatment（P〉0.05）;the plasma Hcy and endothelin after treatment in the research group were significantly lower than those in the control group（P〈0.05）;but the low blood viscosity,high blood viscosity and plasma viscosity in both two groups had no statistically significant differences between before and after treatment（P〈0.05）.Conclusion Irbesartan and hydrochlorothiazide can significantly reduce the blood pressure,serum inflammatory,Hcy and endothelins levels in the patients with hypertension,have no influence on the hemorheologic indexes and no serious adverse reactions,and are safe and reliable.