常用不同二氢吡啶类钙通道阻滞剂对原发性高血压患者血管内皮功能的影响

The Effect of Dihydropyridine Calcium Channel Blockers on Vascular Endothelial Function in Patients with Primary Hypertension

目的:探讨常用不同二氢吡啶类钙通道阻滞剂对原发性高血压患者血管内皮功能的影响。方法:本研究最终纳入468例原发性高血压患者,硝苯地平缓释片组(A组,108例,口服硝苯地平缓释片,10-20mg/次,2次/日)、苯磺酸氨氯地平片组(B组,132例,口服苯磺酸氨氯地平片,5-10mg/次,1次/日)、左旋氨氯地平片组(C组,123例,口服左旋氨氯地平片,2.5-5mg/次,1次/日)、非洛地平缓释片组(D组,105例,口服非洛地平片缓释片,2.5-5mg次,1次/日),于治疗前、治疗后6个月检测各组血清一氧化氮(NO)、内皮素1(ET-1)水平以及血流介导的血管内皮依赖性舒张功能(FMD),并比较各组差异。结果:与治疗前比较,B组和C组患者治疗6个月后NO水平明显升高,ET-1水平下降,FMD升高,较治疗前比较有统计学差异(P<0.05或P<0.01)。结论:苯磺酸氨氯地平及左旋氨氯地平片对原发性高血压患者血管内皮功能可能有较好的保护作用。

Objective:To investigate the effects of different dihydropyridine calcium channel blockers on vascular endothelial function in patients with primary hypertension.Method:A total of 468 patients with hypertension were enrolled.The patients with primary hypertension were randomly divided into 4 groups.They were given respectively nifedipine sustained-release tablets(10-20mg,bid)(group A,n=108),amlodipine besylate tablets(5-10mg,qd)(group B,n=132),Levamlodipine tablets(2.5-5mg,qd)(group C,n=123),felodipine sustained-release tablets(2.5-5mg,qd)(group D,n=105).Vascular endothelial function such as serum nitric oxide(NO),endothelin-1(ET-1),flow mediated dilation(FMD)were detected before and 6 months after treatment.Results:Compared with before treatment,NO level was significantly increased,ET-1 level was decreased and FMD was increased in group B and group C after 6 months of treatment,and the difference was statistically significant(P<0.05 or P<0.01).Conclusion:Amlodipine besylate and levamlodipine may have better protective effects on endothelial function independent of antihypertensive effect.