依那普利和伊贝沙坦对糖尿病合并动脉粥样硬化患者血管内皮功能的影响  

Effect of enalapril and irbesartan on vascular endothelial function in type 2 diabetic patients with atherosclerosis

作　　者：孙大勇[1] 朱平先[1] 黄献文[1] 何学森[1] 钱来生[2] 

机构地区：[1]深圳市龙岗中心医院心内科,广东省518116 [2]中南大学湘雅医学院第二医院心内科

出　　处：《中国心血管病研究》2008年第7期483-486,共4页Chinese Journal of Cardiovascular Research

基　　金：广东省深圳市科技计划项目(No:0703206)

摘　　要：目的比较血管紧张素转换酶抑制剂(ACEI)依那普利5mg和血管紧张素受体拮抗剂(ARB)伊贝沙坦150mg治疗2型糖尿病合并动脉粥样硬化(AS)患者肱动脉内皮功能的变化。方法确诊的2型糖尿病合并AS患者用完全随机设计,将患者分为ACEI组47例,依那普利开始剂量2.5mg/d,逐渐加至5mg/d;ARB组49例,用伊贝沙坦逐渐加量至150mg/d;对照组48例,不用以上药物。疗程3个月以上。血管B超检查患者治疗前、后肱动脉内皮功能的变化。随访3个月。结果ACEI组患者治疗后肱动脉内皮依赖性舒张功能(EDV)从(3.3±2.7)%提高至(5.6±4.2)%(P=0.001),肱动脉非内皮依赖性舒张功能(EIV)从(12.6±7.4)%提高至(12.8±7.1)%(P=0.835);ARB组患者治疗后EDV从(4.4±2.9)%提高到(6.2±3.2)%(P=0.038),EIV从(10.6±5.8)%下降到(9.5±4.7)%(P=0.230);而对照组患者治疗前、后EDV、EIV改变差异无统计学意义(P>0.05)。治疗前、后EDV、EIV变化值比较,ACEI组和ARB组相比差异无统计学意义(P>0.05)。结论依那普利和伊贝沙坦均可改善2型糖尿病合并动脉粥样硬化患者的肱动脉内皮功能。Objective To compare the changes of endothelial function in type 2 diabetic patients with atherosclerosis （AS）after treatment with angiotensin-coverting enzyme inhibitor （ACEI） and angiotensin Ⅱ receptor blocker （ARB）. Methods Totally 144 type 2 diabetic patients with AS were included in this study. The patients were assigned into ACEI group （n=47） with enalapril treatment（starting dose of 2.5 mg）d and graduallyreaching 5 mg/d） ,ARB group （n=49） with irbesartan treatment（with gradual increase of doses till reaching the maximumdaily dose of 150 mg）,and control group （n=48） without the above medication. After a treatment lasting for 3 months, the brachial artery endothelial function was evaluated with two-dimensiona luhrasonography. Results After therapy, endothelium-dependent vasodilation （EDV）of the brachial artery increased from （3.3 ±2.7 ）% to （5.6±4.2）% （P=0.001）, and endothelium-independent vasodilation （EIV）increased from （ 12.6±7.4）% to （ 12.8±7.1 ）%（P= 0.835） in ACEI group. EDV increased from （4.4±2.9）% to （6.2±3.2）% （P=0.038）,while EIV decreased from （10.6±5.8）% to （9.5±4.7）% （P=0.230） in ARB group. No statistical changes in the indices were found after therapy in the control group （P〉0.05）.Comparison of endothelial function in the 3 groups showed no statistical significance in the changes of EDV between ACEI and ARB groups （P=0.853）.No differences were found in the change of EIV in the 3 groups（P=-0.64d,）.Condusion The therapy with 150 mg irbesartan and 5 mg enalapril for 3 months produces similar effects on the endothelial function in these patients.

关 键 词：依那普利 伊贝沙坦 内皮血管 

分 类 号：R541.4[医药卫生—心血管疾病]