硝酸异山梨酯片对原发性高血压患者一氧化氮和内皮素-1水平的影响

The changes of plasma nitric oxide and endothelin-1 in patients with essential hypertension after oral administration of isosorbide dinitrate

目的探讨原发性高血压患者服用硝酸异山梨酯片后血浆一氧化氮(NO)和内皮素-1(ET-1)的变化。方法选择2018年1月至2020年12月在金昌市第一人民医院确诊的原发性高血压患者216例,随机分为观察组和对照组,各108例。观察组在常规治疗基础上加用硝酸异山梨酯片10 mg,口服,3次/d;对照组予常规治疗。根据高血压水平将观察组患者分为轻度亚组、中度亚组及重度亚组,检测并比较观察组、对照组及3个亚组患者治疗前及治疗后2个月NO、ET-1水平。结果治疗前观察组与对照组血浆NO及ET-1比较,差异均无统计学意义(均P>0.05)。治疗后观察组NO水平高于对照组,而ET-1低于对照组,差异均有统计学意义(均P<0.05)。不同亚组治疗前NO和ET-1比较,差异均无统计学意义(均P>0.05)。治疗后轻度亚组NO高于中度及重度亚组,差异均有统计学意义(均P<0.05)。结论服用硝酸异山梨酯片能改善原发性高血压患者血管内皮功能,特别是轻度高血压患者。

Objective To investigate the changes of plasma nitric oxide(NO)and endothelin-1(ET-1)in patients with essential hypertension after oral administration of isosorbide dinitrate.Methods Two hundreds and sixteen patients from January 2018 to December 2020 in the First People's Hospital of Jinchang with essential hypertension were enrolled and randomly divided into observation group(isosorbide dinitrate 10 mg oral qd on the basis of regular treatment,n=108)and control group(regular treatment,n=108).The observation group was divided into mild subgroup,moderate subgroup and severe subgroup based on blood pressure level.Plasma NO and ET-1 were measured before and after 2-month treatment and compared between different groups.Results Plasma NO and ET-1 were not significantly different between the observation group and the control group before treatment(all P>0.05).NO was significantly higher and ET-1 was significantly lower in the observation group than in the control group after treatment(all P<0.05).Plasma NO and ET-1 levels were not significantly different in subgroups before treatment(all P>0.05).NO was significantly higher in mild subgroup than in moderate subgroup and severe subgroup(all P<0.05).Conclusion Oral isosorbide dinitrate can improve vascular endothelial function in patients with hypertension,especially in patients with mild hypertension.