缬沙坦氢氯噻嗪对轻中度原发性高血压患者颈动脉内膜中层厚度的影响

Effects of valsartan hydrochlorothiazide on carotid intima-media thickness in patients with mild to moderate essential hypertension

目的:探究缬沙坦/氢氯噻嗪对轻中度原发性高血压患者颈动脉内膜中层厚度的影响。方法:选取2014年1月至2016年6月北京市海淀医院收治的244例轻中度原发性高血压患者,采用数字随机法分为观察组和对照组各122例,对照组给予氢氯噻嗪口服,观察组则给予缬沙坦/氢氯噻嗪口服,两组患者均连续治疗6个月,对比两组患者治疗前后的血压,并对治疗前后的肱动脉内皮依赖性舒张功能(EDD)、颈动脉内膜中层厚度(IMT)进行对比。结果:治疗后两组患者的血压水平均较治疗前明显降低(P<0.05),治疗前、治疗后两组患者的血压水平对比均无显著差异(P>0.05);对照组治疗后与治疗前相比EDD及IMT水平均无显著改善(P>0.05),观察组治疗后与治疗前相比EDD明显增高,IMT明显降低,差异具有统计学意义(P<0.05),与同期对照组相比差异具有统计学意义(P<0.05)。结论:缬沙坦/氢氯噻嗪用于轻中度原发性高血压患者的治疗能够有效控制血压,并改善肱动脉内皮功能,减少颈动脉内膜中层厚度,值得在临床上推广和应用。

Objective： To investigate efficacy of valsartan hydrochlorothiazide on the thickness of carotid intima-media in patients with mild to moderate essential hypertension. Methods： A total of 244 patients with mild to moderate essential hypertension were enrolled in the study. The patients were divided into two groups： observation group and control group（122 cases）. The patients in the control group were treated with oral hydrochlorothiazide, The patients in the observation group were treated with oral valsartan hydrochlorothiazide. The patients in the two groups were treated continuously for 6 months. The blood pressure before and after treatment were compared between the two groups. The brachial artery endothelium-dependent diastolic function（EDD）, carotid artery intima-media thickness（IMT） were compared. Results： After treatment, the blood pressure levels of the two groups were significantly lower than those before treatment（P〈0.05）. Before treatment, there was no significant difference in blood pressure between the two groups（P〈0.05）. Compared with the control group, the EDD and IMT levels were significantly improved（P〈0.05）. The EDD of the observation group was significantly higher than that of the control group（P〈0.05）, and the difference was statistically significant（P〈0.05） The difference was statistically significant（P〈0.05）. Conclusion： The treatment of patients with mild to moderate essential hypertension in valsartan can effectively control blood pressure and improve the brachial artery endothelial function and reduce the carotid intima-media thickness, which is worthy of clinical application and promotion.