厄贝沙坦氢氯噻嗪对高血压患者血管内皮功能、血流动力学及炎症反应的影响

Effect of irbesartan hydrochlorothiazide on endothelial function,hemodynamics and inflammatory response in hypertensive patients

目的:观察厄贝沙坦氢氯噻嗪对高血压患者血管内皮功能、血流动力学及炎症反应的影响。方法:选择就诊于我院的原发性高血压患者100例为研究对象,根据随机数字表法分为对照组和观察组。对照组50例行常规治疗,观察组50例在此常规治疗基础上口服厄贝沙坦氢氯噻嗪治疗。比较两组血管内皮功能、血流动力学及炎症因子水平的变化。结果:治疗前,两组vWF、EDD、NMD水平,血液流变学水平以及炎性因子水平比较差异无统计学意义(P>0.05)。与治疗前相比,治疗后观察组vWF水平明显降低、EDD水平明显升高(P<0.05),NMD水平无明显变化(P>0.05);而对照组vWF水平明显降低(P<0.05),EDD、NMD水平无明显变化(P>0.05)。治疗后,观察组vWF水平明显低于对照组vWF水平,EDD水平明显高于对照组EDD水平,差异对比均有显著性(P<0.05)。治疗后,观察组LBV、HBV、PV水平较治疗前均显著降低(P<0.05),而对照组LBV、HBV、PV水平与治疗前相比差异不显著(P>0.05)。治疗后,观察组LBV、HBV、PV水平均显著低于对照组相应水平(P<0.05)。治疗后,两组CRP、ICAM-1、MCP-1水平较治疗前均显著降低(P<0.05)。治疗后,观察组CRP、ICAM-1、MCP-1水平均明显低于对照组相应水平,差异有统计学意义(P<0.05)。结论:厄贝沙坦氢氯噻嗪治疗高血压可对患者血管内皮功能、血液流变学水平起到明显的改善作用,且能显著降低机体炎症反应,值得临床推广应用。

Objective： To observe the effect of irbesartan hydrochloride on endothelial function, hemodynamics and inflammatory response in patients with essential hypertension. Method： A total of 100 patients with essential hypertension admitted from May 2015 to August 2017 in our hospital were divided into observation group （ n =50） and control group （ n =50） according to random number table. Thecontrol group was treated with routine treatment, and the observation group was treated with erbesartan hydrochlorothiazide on the basis of routine treatment in the control group. The changes of vascular endothelial function, hemodynamics and inflammatory factors in the two groups were compared. Results： Before treatment, there was no significant difference invWF, EDD and NMD levels, hemodynamicslevel and CRP, ICAM-1 and MCP-1levels（ P 〉0.05）. After treatment, the vWF levelin the observation group was significantly decreased and the EDD level was significantly increased （ P 〈0.05）; while the level of NMD was not significantly changed（ P 〉0.05）. After treatment,the level of vWF in the control group was significantly decreased（ P 〈0.05）; but there was no significant change in EDD and NMD level （ P 〉0.05）. After treatment, vWFlevel（144.94±16.21）% in the observation group was significantly lower than that in the control group; EDD level （6.81±0.74）% was significantly higher than that in the control group （ P 〈0.05）. After treatment, the levels of LBV, HBV and PV in the observation group were significantly lower than those before treatment （ P 〈0.05）, while the levels of LBV, HBV and PV in the control group were not significantly different from those before treatment （ P 〉0.05）. After treatment, LBV level （13.34±1.41） m·pas, HBV level （5.13±1.34） m·pas and PV level （1.65±0.34） m·pas in the observation group were significantly lower than those in the control group（ P 〈0.05）. After treatment, the levels of CRP, ICAM-1 and MCP-1 in both groups were significantly lower than those before treatment （ P 〈0.05）. After treatment, the level of CRP（1.71±0.81） mg/L, ICAM-1 level （330.82±68.51） ng/mL and MCP-1 level （3.02±1.06） g/L in the observation group were significantly lower than those in the control group （ P 〈0.05）. Conclusion： Irbesartan hydrochlorothiazide treatment of hypertension can play a significant role in the improvement of vascular endothelial function and hemorheology in patients, and can significantly reduce the level of inflammatory response in the body, worthy of clinical application.