奥利司他对超重合并高血压患者内皮依赖性血管舒张功能的影响

Effect of Orlistat on Endothelium-Dependent Vasodilation in Overweight Patients With Hypertension

目的 :观察超重合并高血压患者服用奥利司他治疗前后血压和超声肱动脉内皮依赖性血管舒张功能的变化。 方法 :3 0例超重合并轻度高血压患者 (超重高血压组 )服用脂肪酶抑制剂———奥利司他 (orlistat ,商品名 :赛尼可 )12 0mg ,每日 3次 ,共 12周 ,服药前后诊所测量身高、体重、腰围及血压 ,并行肱动脉超声检查 ,测定血流介导的血管舒张功能。 15例非超重的高血压患者作为对照组。 结果 :超重高血压组治疗前加压反应性充血后肱动脉内径平均增加 (9 6± 1 7) % ,流速增加 (2 9 7± 3 0 5 ) % ,增加幅度低于对照组 ,与对照组比有显著性差异 (P <0 0 1)。超重高血压组奥利司他治疗 12周后 ,加压反应性充血后肱动脉内径增加达 (14 2± 2 0 ) %、流速增加达 (5 6 7± 4 14 ) % ,血流介导的血管舒张功能较治疗前显著改善 (P均 <0 0 1)。超重高血压组患者治疗后平均减重 5 3kg ,腰围减少 6 3cm ,收缩压 /舒张压平均下降 13 3 /5 7mmHg (1mmHg=0 13 3kPa) ,与治疗前比有显著性差异 (P均 <0 0 5～ 0 0 1)。 结论 :奥利司他能降低超重合并高血压患者的体重 ,并能改善血流介导的内皮依赖性动脉舒张功能。

Objective:To evaluate the effect of orlistat on blood pressure and endothelium-dependent vasodilation by ultrasound in overweight hypertensives. Methods:Thirty overweight patients with mild hypertension took orlistat 120 mg tid for 12 weeks(overweight hypertension group).The height,weight,waist circumference and blood pressure were measured and flow-mediated dilatation (FMD) of brachial artery was determined by ultrasound before and after treatment.Fifteen non-overweight hypertensive patients served as control group. Results:Before treatment,brachial artery diameter increased by 9.6% following reactive hyperemia in overweight hypertension group,significantly lower than that in control group (p<0.01);while after orlistat treatment,it increased by 14.2%,blood flow velocity increased by 56.7% and FMD was improved significantly (p<0.01).Weight was lost by 5.3 kg,waist circumference decreased by 6.3 cm and SBP/DBP by 13.3/5.7 mmHg(p<0.05) after orlistat treatment in overweight hypertensives. Conclusion:Orlistat can decrease weight,and improve endothelium-dependent FMD in overweight patients with hypertension.