缬沙坦对冠心病合并高血压病患者动脉弹性的影响  

Impact of Valsartan on Arterial Stiffness in Patients with Coronary Heart Disease and Hypertension

作　　者：龙达[1] 刘启明[1] 

机构地区：[1]中南大学湘雅二医院,湖南长沙410011

出　　处：《医学临床研究》2010年第3期436-438,共3页Journal of Clinical Research

摘　　要：【目的】探讨血管紧张素Ⅱ受体拮抗剂缬沙坦和钙拮抗剂氨氯地平对冠心病合并高血压病患者动脉弹性影响的差异。【方法】对75名冠心病合并高血压病患者测量主动脉中心动脉压和臂-踝脉搏波传导速度（ba—PWV），35例服用缬沙坦160mg／d（缬沙坦组），40例服用氨氯地平5～10mg／d（氨氯地平组）控制高血压。药物治疗24周后复查ba—PWV和主动脉中心动脉压。【结果】24周后缬沙坦组和氨氯地平组之间冠状动脉病变Gensini积分、左心室射血分数、心率等差异无显著性（P〉0．05），两组患者药物治疗后肱动脉和中心动脉收缩压、舒张压和脉压差较治疗前显著下降。两组间治疗前ba-PWV差异无显著性（12．6±2．6）比（12．1±2．6）（P〉0．05），治疗后缬沙坦组ba—PWV明显降低（12．6±2．6比10．8±1．9，P〈0．01），而氨氯地平组ba-PWV改变无统计学意义（12．1±2．6比11．4±2．7，P〉0．05）。【结论】缬沙坦较氨氯地平在同等降低肱动脉和中心动脉血压水平的基础上可以明显改善其动脉弹性。[Objective] To compare the effects of angiotensin Ⅱ receptor blocker valsartan and calcium channel blocker amlodipine on arterial stiffness in patients with coronary heart disease combined with hypertension. [Methods] Seventy five patients with coronary heart disease combined with hypertension accepted brachi- al-ankle pulse wave velocity （ba-PWV） and central aortic blood pressure measurement. Valsartan group（ n = 35） was administered to take valsartan in a dose of 160mg per day. Amlodipine group（ n = 40） was adminis trated to take amlodipine 5-10 mg per day to ensure equivalent blood pressure（BP） control. Measurements of ba-PWV and central aortic BP were carried out again after 24 weeks. [Results] After 24 weeks, there were no statistical differences in coronary artery Gensini score, left ventricular ejection fraction, mean heart rate and types of therapy medication between valsartan group and amlodipine group （ P 〉0.05）. Systolic blood pres- sure, diastolic blood pressure and pulse blood pressure of brachial artery as well as central artery between baseline level and end of the study had no statistical differences between two groups （ P 〉0.05）, and had significant decrease in both groups （ P 〈0.01）. The levels of central artery BP and brachial BP controlled by valsartan were similar to amlodipine. There were no significant differences in ba-PWV between two groups at baseline （12.6± 2.6 vs 2.1 ±2.6, P 〉0.05）. However, a significant decrease was observed in valsartan group after 24 weeks （12. 6±2. 6 vs 10.8 ±1.9, P 〈0.01）, while no significant changes appeared in amlodipine group （12.1±2.6 vs 11.4 ±2.7, P 〉0.05）. [Conclusion] Valsartan may improve arterial stiffness to a significantly greater extent than amlodipine despite similar central artery and brachial BP control.

关 键 词：冠状动脉疾病/并发症 高血压/药物疗法 四唑类/治疗应用 缬氨酸/类似物和衍生物 

分 类 号：R543.3[医药卫生—心血管疾病]