非洛地平对高血压患者大动脉内皮功能和左室肥厚的影响

Effects of felodipine on endothelial function and atherosclerosis progression of large arteries and left ventricular hypertrophy in hypertensive patients

目的 :探讨非洛地平对高血压病患者大动脉内皮功能、粥样硬化斑块及左室肥厚的影响。方法 :将高血压患者随机分为非洛地平治疗组和吲达帕胺治疗组 (各 40例 ) ,另设年龄、性别与之匹配的正常人作为对照组 (n =40 )。用高分辨超声技术检测各组对象的肱动脉内皮依赖性舒张功能、颈动脉平均内中膜厚度、颈动脉斑块发生率、Crouse积分及心脏超声。对非洛地平组、吲达帕胺组分别在治疗 3个月、1a后复查血压和心脏血管超声的上述指标。结果 :与对照组比较 ,非洛地平组和吲达帕胺组肱动脉内皮依赖性舒张功能减退 ,颈动脉内中膜增厚 (P <0 0 5 ) ,并出现左室肥厚。非洛地平组与吲达帕胺组在降低血压及改善血管内皮依赖性舒张功能及逆转左室肥厚方面作用相同 (P >0 0 5 ) ,但非洛地平组在逆转颈动脉中膜厚度、降低新的粥样斑块发生率方面作用优于吲达帕胺组 (P <0 0 5 )。结论 :非洛地平除能有效降低高血压患者的血压外 ,还能逆转心脏和大动脉功能和结构异常 。

Objective To investigate the effect of treatment with felodipine on endothelial function and atherosclerosis progression of large arteries and left ventricular hypertrophy in hypertensive patients.Methods The patients with essential hypertension were randomly divided into group A treated with felodipine(n=40) and group B treated with indapamide(n=40),and another 40 healthy subjects as group C(control group) with matched age and sex .The humeral arterial endothelium-dependent vasodilatation and carotid arterial mean intimal-medial thickness and carotid plaques and left ventricular structure were measured with high resolution ultrasonography for each group.For groups A and B all above indices and blood pressure were measured again after 3 month,1 year of treatment respectively.Results Compared with group C,group A and B had lower humeral arterial endothelium-dependent vasodilatation and thicker carotid mean intimal medial thickness (P<0.01).There was no difference in reduction of blood pressure and left ventricular hypertrophy and improvement of humeral arterial endothelium-dependent vasodilatation between group A and B(P>0.05).Compared with group B,group A had a significantly better effect on normalizing carotid mean intimal medial thickness and decreasing the incidence of new plaques(P<0.01).Conclusion In addition to reduction of blood pressure,felodipine has an effect on regression of abnormal function and structure of large arteries,which may delay the progression of atheroclerosis,remoding the left ventricular hypertrophy.