硝苯地平控释片降压对老年高血压内皮功能及颈动脉内中膜的影响

Effects of Nifedipine Liberant on Endothelial Function and Intima - media Thickness of Carotid Arteries in Elderly Hypertensive Patients

目的:了解硝苯地平控释片降压治疗对老年高血压患者血管内皮依赖性舒张功能、颈动脉内膜中层厚度(IMT)及血浆内皮素(ET)、一氧化氮(NO)的影响。方法:采用高分辨率超声技术,检测38例对照及40例原发性高血压患者降压治疗前后,休息时、反应性充血后的肱动脉内径变化并检测颈动脉IMT值,测定治疗前后血浆ET、NO浓度变化。结果:与对照组比较,老年高血压组肱动脉血流介导性舒张明显减弱,NO明显低于对照组,ET水平明显高于对照组。老年高血压2级及3级颈动脉IMT值及IMT与内径的比率,均比对照组明显增大。服硝苯地平控释片30mg,治疗6个月后,血压明显下降,肱动脉内皮依赖性舒张较治疗前明显改善,但仍低于对照。血浆ET水平明显下降,NO水平明显升高。治疗前后颈动脉IMT无显著性改变。结论:1.老年高血压患者存在内皮分泌失衡及内皮依赖性舒张功能障碍。2.老年高血压2级及3级颈动脉IMT值较对照组明显增大。3.经硝苯地平控释片降压治疗6个月后,血管内皮功能明显改善,而颈动脉IMT无明显改善。

Objective: To investigate the effect of nifedipine liberant on endothelium - dependent relaxing function, intima - medi-a thickness (IMT) of carotid and the changes of plasma endothelin (ET), nitric oxide (NO) levels in elderly hypertensive patients. Methods: With high - resolution Itrasound .before and after control - release nifedipine treatment, were measured endothelium - dependent relaxing function and IMT of carotid arteries were measured in 40 subjects: with essential hypertension and 38 controls, and. the serum ET, NO, levels of all patients wen: also tested.Results: In elderly hypertensive patients, IMT of carotid arteries was higher and flow - mediated dilatation was much reduced compared with control group. Serum ET level was much higher and NO level was much lower than control group. After therapy with nifedipine liberant 30mg for 6 months, blood pressure was much reduced , and flow - mediated vasodilation was greater than before treatment, though it was still lower than control group. The plasma ET levels were decreased, NO level was increased markedly after nifedipine liberant. There was no significant change of IMT of carotid arteries. Conclusion: 1. Endothelium secreting function and endothelum - dependent vasodilation was impaired in elderly patients with primary hypertension. 2. IMT of carotid arteries was increased in elderly hypertensive patients. 3. Nifedipineliberanl improves impaired endothelium - dependent vasodilatation, but with little effect on increased intima - media thickness of carotid arteries.