长期抗高血压治疗对肱动脉重构的影响  

Effects of long term antihypertensive therapy on vascular remodeling of humeral artery in patients with hypertension

作　　者：翟丽华[1] 李光展[1] 吴瑛[1] 梁旭[1] 杨纯玉[1] 

机构地区：[1]暨南大学医学院第二附属医院

出　　处：《中国老年学杂志》2004年第8期694-696,共3页Chinese Journal of Gerontology

基　　金：深圳市医药卫生科技计划项目 (1 9980 70 0 8)

摘　　要：目的　探讨长期应用氨氯地平和 /或培哚普利对肱动脉结构及功能的影响。方法　将高血压病患者随机分为A组 (氨氯地平组 ,n=33)和B组 (培哚普利组 ,n =35) ,治疗半月后血压仍≥ 1 4 0 / 90mmHg者进入C组 (氨氯地平 +培哚普利组 ,n =31 ) ;另设同期体检的老年人为D组 (对照组 ,n =33)。用高分辨超声技术检测各组的肱动脉内中膜厚度 (IMT)、内径 (r)、IMT/r比值、内皮依赖舒张功能 (FMD)和肱动脉横断面顺应性(CSC)。对A、B、C 3组分别在治疗后 1年、2年、3年时复查血压和肱动脉的上述超声指标。结果　与对照组比较 ,高血压各组IMT增厚 (A、B组P <0 0 5 ,C组P <0 0 1 )、FMD和CSC减退 (均P <0 0 1 )。治疗后A、B、C 3组的血压、IMT、IMT/r和FMD与基线比较均显著改善。组间比较 ,C组FMD及CSC改善较A、B组显著 (1 6 85± 3 62vs 1 2 87± 1 54 ,1 6 85± 3 62vs 1 2 69± 1 40 ,P <0 0 1 ;1 8 66± 4 67vs 1 5 1 2± 2 62 ,1 8 66± 4 67vs 1 4 83±2 1 8,P <0 0 1 )。结论　长期应用氨氯地平和 /或培哚普利能够改善肱动脉结构和功能的异常 。Objective To investigate the long term effects of amlodipine and perindopril on the structure and function of humeral artery in patients with hypertension. Methods The patients with essential hypertension were randomly divided into group A (treat with amlodipine, n =33) and group B (treat with perindopril, n =35). Among them, the patients whose blood pressure was over or equal to 140/90 mmHg after half month treatment were as group C (treat with amlodipine and perindopril, n =31). The healthy subjects worked as group D (controls group, n =33), whose age and sex matched with group A, B and C. The humeral arterial intimal medial thickness (IMT), lumen diameter(r), IMT/r, flow mediated vasodilation (FMD) and cross sectional compliance (CSC) were measured with high resolution ultrasonography for each group. For groups A, B and C, all above indices and blood pressure were measured again after 1 year, 2 years and 3 years of treatment respectively. Results Compared with group D, group A, B and C had thicker IMT (A, B groups, P <0.05, C group, P <0.01, respectively) and lower FMD and CSC ( P <0.01 both). After treatment, the indices of blood pressure, IMT, IMT/r and FMD were all improved compared with baseline. Compared with group A and B, group C had higher FMD and CSC (16.85±3.62 vs. 12.87±1.54, 16.85±3.62 vs. 12.69±1.40, 18.66±4.67 vs. 15.12±2.62, 18.66±4.67 vs. 14.83±2.18,P<0.01, respectively). Conclusions Long term antihypertensive therapy with amlodipine and/or perindopril has effects on regression of the abnormalities of structure and function of humeral artery. Combining the two drugs, we can even obtain better effects on function indices.

关 键 词：钙通道阻滞药 血管紧张素转换酶抑制剂 高血压 动脉 

分 类 号：R541.4[医药卫生—心血管疾病]