左旋氨氯地平和氨氯地平对高血压病人内皮功能及血清胆固醇影响

Effects of l-amlodipine and amlodipine on vascular endothelial function and serum cholesterol in patients with essential hypertension

目的 :比较左旋氨氯地平及氨氯地平对原发性高血压 (EH)病人血管内皮功能及血清胆固醇的影响。方法 :将 6 0例EH病人随机分为 2组A组 ,用左旋氨氯地平 2 .5mg ,po ,qd ;B组用氨氯地平 5mg ,po ,qd。并设健康对照组 ,不用任何药物。6wk后测量结果 ,将 2药交叉继续用药 6wk复测各数值。对内皮功能与高血压危险分层进行相关分析。结果 :应用 2药 6wk ,2组肱动脉反应性充血时内径变化率 (FMD)较治疗前有明显改善 ,分别为(4±s 4 ) %vs (6± 7) % (P <0 .0 1) ,(3± 4 ) %vs(6± 8) % (P <0 .0 1) ,2组间比较无显著差异 (P >0 .0 5 ) ,2药交叉治疗后结果不变。 2组治疗后 12wk血清胆固醇水平下降。FMD(% )与病人高血压危险分层间呈负相关。结论 :左旋氨氯地平与氨氯地平均可改善高血压病人内皮功能 ,效果相似。 2药可轻度降低血清胆固醇。

AIM: To compare the effects of l amlodipine and amlodipine on endothelial function and serum cholesterol in patients with essential hypetensive(EH). METHODS: Sixty patients were randomly divided into either l amlodipine 2.5 mg daily or amlodipine 5 mg daily groups.Healthy subjects were selected as control group without using any drug. After 6 wk treatment the brachial artery diameters and serum cholesterol levels were measured. Both drugs were crossed after 6 wk, the brachial artery diameter and serum cholesterol level were measured again. The changes of each object were analysed. The effects of two drugs were compared. The relativity between endothelial function and hypertensive risk rank was analysed. RESULTS: The FMD(%) were all improved in both l amlodipine and amlodipine groups compared with base line ((4±4)% vs (6±7)%, P < 0.01, (3±4)% vs (6±8)%, P < 0.01)) after 6 wk treatment with l amlodipine or amlodipine. There was no difference between both EH groups ( P > 0.05). After crossing the two drugs the same result was got. After 12 wk treatment the serum cholesterol levels decreased significantly in both groups ( P < 0.05). The two groups had no difference ( P > 0.05). The changes of FMD(%) have a negative correlation with the hypertensive risk rank. CONCLUSION:Both l amlodipine and amlodipine can improve the endothelial function of hypertensive patients. They can decrease the serum cholesterol level simultaneously. The endothelial function decreased with the increasing of hypertensive risk rank.