氨氯地平对2型糖尿病合并高血压患者血管内皮功能的影响

Effect of amlodipine on the endothelium-dependent relaxing function of brachial artery in hypertensive patients with type 2 diabetes mellitus

目的 探讨氨氯地平治疗前后 2型糖尿病合并高血压患者血管内皮功能的变化。 方法 经 2周导入期后 ,将 75例 2型糖尿病合并高血压患者 ,随机分为氨氯地平组 (3 8例 )和美托洛尔组 (3 7例 ) ,以血压 <14 0 / 90mmHg为标准调整剂量 ,未达标者加吲哒帕胺 ,治疗期 6周。超声检测治疗前后右肱动脉血管内皮功能的变化。 结果 美托洛尔组治疗前后肱动脉内径基础值 (3 .69± 0 .5 8mm对 3 .71± 0 .60mm)、反应性充血后 (5 .41%± 0 .82 %对 5 .78%± 0 .87% )及含服硝酸甘油后内径变化 (19.6%± 4.8%对 2 0 .0 %± 5 .2 % )均无显著性差异 (P均 >0 .0 5 )。氨氯地平组治疗前后肱动脉内径基础值 (3 .72± 0 .61mm对 3 .70± 0 .5 9mm)、含服硝酸甘油后内径变化 (18.9%± 4.5 %对 2 0 .1%± 5 .6% )也无显著性差异 (P均 >0 .0 5 ) ;但反应性血管充血引起肱动脉内径的变化 (5 .66%± 0 .78%对 9.48%± 3 .80 % )有非常显著性差异 (P <0 .0 1)。 结论 氨氯地平在有效降低 2型糖尿病合并高血压患者血压的同时 ,能独立地改善其血管内皮功能。

Objective To study the effect of amlodipine on the endothelium dependent relaxing function of brachial artery in hypertensive patients with type 2 diabetes mellitus. Methods Followed 2 week run in, 75 hypertensive patients with type 2 diabetes mellitus were divided randomly into amlodipine group(38 cases) and metoprolol group (37 cases) for 6 weeks. Some patients were added indapamide, according to the status of blood pressure. Endothelium dependent relaxing function of brachial artery was measured with B mode ultrasound. Results In metoprolol group, the inner diameters of brachial artery were no significant difference in baseline, response to nitroglycerin and responsive congestion pre and post treatment (P all>0.05). In amlodipine group, there were no significant difference in baseline and response to nitroglycerin pre and post treatment yet(P all>0.05), but there was a significant difference in responsive congestion of brachial artery pre and post treatment (P<0.01). Conclusion Amlodipine can reduce the blood pressure and improve endothelium dependent relaxing function of blood vessels in hypertensive patients with type 2 diabetes mellitus.