奥利司他对肥胖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 obese patients with hypertension

目的 观察肥胖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 30例肥胖合并轻度高血压患者(肥胖高血压组)服用脂肪酶抑制剂——奥利司他120 mg,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(FMD)。15例非肥胖的高血压患者作为对照组。结果 肥胖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％,增加幅度显著低于对照组(P<0.01);而奥利司他治疗12周后,加压反应性充血后肱动脉内径增加达14.2％、流速增加达56.7％,FMD较治疗前显著改善(均P<0.01)。肥胖高血压组患者治疗后平均减重5.3 kg,腰围减少6.3 cm,收缩压/舒张压平均下降13.3/5.7 mmHg(1mmHg=0.133kPa),与治疗前比较有显著性差异(均P<0.05)。结论 奥利司他能降低肥胖合并高血压患者的体重及收缩压和舒张压,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 obese patients with hypertension. Methods Thirty obese patients with mild hypertension took orlistat 120mg tid for 12 weeks(obese hypertension group). The height, weight, abdomen circumference and blood pressure were measured and flow-mediated dilation (FMD) of brachial artery was determined by ultrasound before and after treatment. Fifteen non-obese hypertensive patients served as control group.Results Before treatment, brachial artery diameter increased by 9.6% following reactive hyperemia in obese 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 5.3kg, waist circumference decreased by 6.3cm and SBP/DBP by 13.3/5.7 mmHg (P<0.05) after orlistat treatment in obese patients with hypertension. Conclusion Orlistat can decrease body weight and SBP/DBP and, improve endothelium-dependent FMD in obese patients with hypertension.