血管紧张素转换酶抑制剂对动脉弹性的影响

The Effect of Angiotensin Converting Euzyme Inhibiter on Vascular Distensibility

目的 :评价血管紧张素转换酶抑制剂 (angiotensinconvertingenzymeinhibitor ,ACEI)降压治疗中对血管的保护作用。方法 :对 2 5例原发性高血压患者应用美国DP2 0 0M动脉仪测定肱动脉血压 ,提供动脉压力波形、顺应性、阻力和弹性参数 ,并应用ACEI西拉普利 (一平苏 )降压治疗 ,比较治疗前后上述指标的变化。结果 :与ACEI治疗前相比 ,治疗后系统血管顺应性(systemicvascularcompliance ,SVC )及肱动脉顺应性 (brachialarterycompliance ,BAC)明显增强 ,分别为 :1.0 86± 0 .31和1.11± 0 .2 6ml/mmHg ,P <0 .0 0 1(SVC ) ,0 .6 37± 0 .36 8和 0 .6 94± 0 .2 89ml/mmHg ,P <0 .0 0 1(BAC)。系统血管阻力 (sys temicvascularresistance ,SVR)降低 (1739.10± 346 .89和 16 82 .94± 394 .75dynes/s/cm5) ,P <0 .0 0 1。肱动脉阻力 (brachialarteryresistance ,BAR)降低 (2 86 .4 4± 187.19和 2 16 .38± 15 1.2 2dynes/s/cm5) ,P <0 .0 0 1。肱动脉弹性 (brachialarterydisten sibility ,BAD)增强 (5 .2 1± 1.95和 5 .39± 1.4 3% /mmHg)。脉压 (pulsepressure,PP)下降 (6 7.2 5± 16 .5 8和 6 4 .38± 18.1mmHg)P <0 .0 0 1。同时伴血浆血管紧张素II(AngII)下降 ,P <0 .0 0 1。多因素分析结果显示

Objective: To evaluate the curative effect of angiotensin converting enzyme inhibitor (ACEI) on the vascular protection of hypertensive patients.Methods: 25 primary Hypertensive patients were studied. The DP200 non-invasive blood pressure monitor was used to measure brachial artery pressure of patients before therapy. The arterial pressure waveform, arterial compliance, resistance and elasticity parameters were recorded. the patients began to take ACEI. After a course of treatment, After that, the parameters were measured again after therapy. The parameters were compared before and after therapy.Results:After the therapy, systemic vascular compliance (SVC) and brachial artery compliance (BAC) increased significantly. SVC increased from 1.086±0.31 ml/mmHg to 1.11±0.26 ml/mmHg (P<0.001), BAC increased from 0.637±0.368 ml/mmHg to 0.694±0.289 ml/mmHg (P<0.05). BAD improved from 5.21±1.95%/mmHg to 5.39±1.43%/mmHg. PP decreased from 67.25±16.58 mmHg to 64.38±18.14 mmHg(P<0.001),SVR decreased from 1739.10±346.89 dynes/s/cm 5 to 1682.94±394.75 dynes/s/cm 5 (P<0.001), BAR decreased from 286.44±187.19 dynes/s/cm 5 to216.38±151.22 dynes/s/cm 5(P<0.001). AngⅡdecreased significantly. Binary logistic regression analysis showed that PP, BAC, SVR and BAD were all related with SVC.Conclusion:The patients with the hypertension for years will turn up the abnormal of artery distensibility. ACEI can improve the artery distensibility and decrease pulse pressure. Therefore, ACEI may delay and decrease the occurrence of the complication of cardio-cerebral vascular disease.