替米沙坦/氢氯噻嗪片和氯沙坦钾/氢氯噻嗪片的降压疗效和对血管内皮功能的影响研究  

Comparison study of telmisartan/hydrochlorothiazide tablets and losartan potassium/hydrochlorothiazide tablets on antihypertensive efficacy and reversing vascular endothelial dysfunction

作　　者：胡泽平[1] 王邦宁[1] 刘和俊[1] 陈大年[1] 刘敏[1] 骆志刚[1] 

机构地区：[1]安徽医科大学第一附属医院心内科一病区,合肥230022

出　　处：《中国实用内科杂志》2009年第12期1109-1111,共3页Chinese Journal of Practical Internal Medicine

基　　金：安徽省科技攻关计划项目(06013129B)

摘　　要：目的比较替米沙坦/氢氯噻嗪片和氯沙坦钾/氢氯噻嗪片对高血压患者的降压疗效和对血管内皮功能的影响。方法将2004年9月至2006年5月安徽医科大学第一附属医院收治的61例高血压患者随机分为替米沙坦/氢氯噻嗪组31例和氯沙坦钾/氢氯噻嗪组30例,治疗8周。统计治疗后的血压控制率和测定治疗8周前后血清肝细胞生长因子(HGF)、血清一氧化氮(NO)和血浆内皮素(ET)水平。结果(1)治疗8周后两组收缩压(SBP)、舒张压(DBP)均明显下降(P均<0.01),但两组间治疗前、治疗2周、4周、8周的SBP、DBP和血压控制率差异无统计学意义(P均>0.05);(2)与正常对照者相比高血压患者血清HGF、血浆ET明显增高,血清NO明显降低(P均<0.01),治疗8周后两组血清HGF、血浆ET明显下降,血清NO明显升高(P均<0.01),两组血清HGF下降幅度(△HGF)、血清NO升高幅度(△NO)差异无统计学意义(P均>0.05),而血浆ET下降幅度(△ET)、△ET/△NO比值差异有统计学意义(P均<0.01)。结论(1)治疗8周两药降压效果相似;(2)两药都能逆转血管内皮功能不全,但替米沙坦/氢氯噻嗪片可能强于氯沙坦钾/氢氯噻嗪片。Objective To compare the different effects on antihypertensive efficacy and reversing vascular endothelial dysfunction（VED） of hypertensive patients by Telmisartan/Hydrochlorothiazide or Losartan Potassium/Hydrochlorothiazide tablets. Methods 61 hypertensive patients were randomly divided into Telmisartan/Hydrochlorothiazide group and Losartan Potassium/Hydrochlorothiazide group and received the treatment with Telmisartan/Hydrochlorothiazide tablets or Losartan Potassium/Hydrochlorothiazide tablets 1 tablet per day for 8 weeks. The rates of under control were calculated. Serum hepatocyte growth factor （ HGF）, serum nitric oxide （ NO ） and plasma endothelin （ET） were measured before and after treatment. Results （ 1 ） After 8-week treatment SBP and DBP in either group were significally decreased （ P 〈0. 01 ）, but SBP, DBP and the rates of under control were not different between two groups （ P 〉 0. 05 ）. （ 2 ） The levels of serum HGF and plasma ET were higher in hypertensive patients, and the levels of serum NO were lower than those in normal（ P 〈 0. 01 ）. The levels of serum HGF and plasma ET after treatment were lower group and the levels of serum NO were higher than those before treatment（ P 〈 0. 01 ）, the levels of serum A HGF and A NO after treatment were not different between two group（P 〉0. 05） ,but the levels of plasma △ET and △ET/△NO ratio were significally different（P 〈 0. 01 ）. Conclusion （ 1 ） After 8-week treatment two drugs have the same antihypertensive efficacy. （ 2 ） Both drugs have some effects on reversing VED of hypertensive patients, but Telmisartan/hydrochlorothiazide tablets is possiblely better than Losartan potassium/hydrochlorothiazide tablets in reversing VED.

关 键 词：抗高血压药 高血压 血管内皮功能不全 

分 类 号：R5[医药卫生—内科学]