缬沙坦和尼群地平对原发性高血压患者血清可溶性粘附分子影响的对比研究

Effects of valsartan versus nitrendipine on soluble adhesion molecules in patients with essential hypertension

目的 对比研究缬沙坦和尼群地平对原发性高血压 (EH )患者血压及血清可溶性粘附分子sICAM 1,sVCAM 1水平的影响。方法 随机对照方法设计 ,将 6 4例轻中度原发性高血压患者分为两组 ,分别予缬沙坦 (80mg/d)和尼群地平 (10～ 30mg/d)治疗 6周 ,治疗前后抽血 ,用酶联免疫方法 (ELISA)测定外周血清中可溶性粘附分子sICAM 1,sVCAM 1水平。另选择 2 5例健康人作为对照组。结果 治疗前与对照组比较 ,高血压患者血清中可溶性粘附分子sICAM 1,sVCAM 1水平升高 ,分别为 [(318 2± 2 7 5 ) μg/Lvs (2 71 5± 2 6 8) μg/L ,P <0 0 5 ]和 [(5 90 6± 4 0 1) μg/Lvs (4 17 9± 38 7) μg/L ,P <0 0 1]。治疗后两组的血压均明显下降 (P <0 0 5 ) ,两组间无差异。缬沙坦组可溶性粘附分子sICAM 1,sVCAM 1水平均较治疗前明显下降 ,分别为[(32 0 5± 2 3 6 ) μg/Lvs (2 80 2± 2 5 4 ) μg/L ,P <0 0 5 ]和[(5 86 2± 4 2 5 ) μg/Lvs (4 5 1 2± 38 9) μg/L ,P <0 0 1]。而尼群地平组可溶性粘附分子sICAM 1,sVCAM 1水平较治疗前无明显下降 (P >0 0 5 )。结论 与尼群地平比较 ,缬沙坦不仅能有效降低血压 ,还能抑制血管壁的炎症反应 ,有利于预防和延缓动脉粥样硬化的发生和发展。

Objectives To study the effect of valsartan versus nitrendipine on blood pressure and soluble adhesion molecules in patients with essential hypertension. Methods\ 64 patients with mild to mo- derate essential hypertension(EH) were randomized into two groups and treated with valsartan(80 mg/d) and nitrendipine(10～30 mg/d) for a 6-week period. These patients were compared against a control population without essential hypertension. Soluble adhesion molecules were measured by enzyme-linked immunoadsordent assay (ELISA) before and 6 weeks after treatment. Results\ Compared with the contral group,the serum levels of sICAM-1 and sVCAM-1 in patients with essential hypertension were increased significantly [(318.2±27.5) μg/L vs (271.5±26.8) μg/L, P <0.05 and (590.6±40.1) μg/L vs (417.9±38.7) μg/L, P <0.01]. After 6 weeks monotherapy, the two drugs induced significant reduction in blood pressure ( P <0.05) and the extent of reduction of each group was similar, compared to each group P >0.05. The levels of sICAM-1 and sVCAM-1 in patients treated with valsartan reduced significantly [(320.5±23.6) μg/L vs (280.2±25.4) μg/L, P <0.05 and (586.2±42.5) μg/L vs (451.2±38.9) μg/L, P <0.01],but there were no significant changes in patients treated with nitrendipine. Conclusions\ These findings suggest that valsartan, an AT 1 receptor inhibitor, can effectively reduce blood pressure and, compared with nitrendipine, inhibit mechanisms of inflammation in the vasculature. This may retard the progress of atherosclerosis.