5-单硝酸异山梨醇酯改善高血压患者血压以及血管弹性的临床观察

Isosorbide-5-mononitrate Reduces Blood Pressure and Improves Arterial Elasticity in Essential Hypertension

目的 观察 5-单硝酸异山梨醇酯 (IS 5 MN)对脉压≥ 60mmHg高血压患者动脉弹性功能、反射波及血压的影响。方法 选取符合入选条件的 3 0例原发性高血压患者 ,分两组进行单盲、安慰剂对照研究 ,每组 15人分别给予IS 5 MN(3 0mg/d)或安慰剂 ,疗程四周。标准袖带水银血压计测量肱动脉血压 ,自动脉搏波速度测定仪测定颈动脉 -股动脉脉搏波传导速度 (CF PWV) ,DO 2 0 2 0动脉功能测定仪获得大动脉和小动脉弹性指数 (C1和C2 ) ,桡动脉压力波形分析获得中心动脉压、外周反射波增压及增强指数。结果 校正安慰剂效应后 ,(1)患者CF PWV明显减慢 ,C1显著提高 ,C2 无明显改变。 (2 )反射波增压和增强指数明显下降。 (3 )外周和中心动脉收缩压和脉压显著降低。结论 5-单硝酸异山梨醇酯明显改善脉压≥ 60mmHg高血压患者的大动脉弹性 ,减弱外周波反射 。

Objectives To investigate the effects of isosorbide-5-mon onitrate(IS-5-MN) on arterial elasticity, wave reflection and blood pressure in essential hypertensives with pulse pressure being 60 mmHg or above. Methods It is a single-blind placebo-contr olled study. 15 eligible patients received IS-5-MN(30 mg/d) therapy for 4 weeks, 15 eligible patients were given placebo. Brachial blood pressure was measured by standardized mercury cuff sphygmomanometer. Automatic pulse wave velocity(PWV) measurement system and DO-2020 arterial pulse contour instrument were applied to examine carotid-femoral PWV(CF-PWV) and large and small arterial elastic indexes (C 1 and C 2) respectively. Central arterial pressure, augmentation pressure and augment index(AI) were acquired by using the radial pulse wave analysis system. Results (1)After IS-5-MN treatment CF-PWV was slowed significantly, and the value of C 1 higher, whereas C 2 had no apparent change. (2) Both augmentation pressure and AI in treatment group were dropped significantly. (3) The systolic pressure and pulse pressure of peripheral and central artery were decreased significantly. Conclusion IS-5-MN improved the large artery elasticity and attenuated wave reflex amplitude.\ It reduced systolic pressure and pulse pressure in essential hypertensives with pulse pressure being 60 mmHg or above.