高血压患者血管内皮功能和血清脂肪细胞因子的变化及氯沙坦干预的作用  

Change of vascular endothelial function,serum adipocyte factors in hypertensive patients and the effect of losartan

作　　者：康国强[1] 陈树强[2] 程祖建[3] 林志鸿[1] 蔺佩鸿[1] 晋学庆[4] 

机构地区：[1]福建医科大学附属第一医院急诊科,福州350005 [2]福建医科大学附属第一医院超声影像科 [3]福建医科大学附属第一医院检验科 [4]福建医科大学附属第一医院心内科

出　　处：《临床心血管病杂志》2012年第10期774-777,共4页Journal of Clinical Cardiology

基　　金：福建省卫生厅青年科研基金(No:2008-2-26)

摘　　要：目的:观察高血压患者血管内皮功能和血清脂肪细胞因子的变化,探讨氯沙坦干预的作用。方法:入选230例首诊轻中度高血压患者,给予氯沙坦50～100mg,qd,共12周;另入选同期健康体检者200例为对照组。观察高血压患者治疗前后血流介导的肱动脉内皮依赖性血管舒张功能(FMD)、血清脂联素、瘦素和抵抗素的变化。结果:治疗前,与对照组比较,高血压组患者的血压、瘦素和抵抗素水平明显升高,而FMD和脂联素水平明显降低(均P<0.05)。氯沙坦治疗12周后,与治疗前比较,高血压组患者血压下降,FMD提高,脂联素水平上升,瘦素和抵抗素水平降低(均P<0.05)。Pearson相关分析显示,FMD与收缩压(r=-0.66)、TC(r=-0.53)、瘦素(r=-0.60)和抵抗素(r=-0.55)呈负相关(均P<0.05),与脂联素(r=0.73)呈正相关(P<0.05)。多元线性逐步回归显示,校正年龄、性别、血压、血脂、血糖等因素后,脂联素、瘦素和抵抗素是FMD的影响因素(均P<0.05)。结论:氯沙坦改善高血压患者血管内皮功能可能与调节脂肪细胞因子代谢有关。Objective：To study the change of vascular endothelial funtion and serum adipocyte factors in hypertensive patients, and the effect of losartan. Method：The 230 hypertensive patients were enrolled and treated with losartan 50--100 mg, qd for 12 weeks. The 200 healthy subjects were served as control group. Vascular endothe- lial function （FMD）, adiponectin, leptin and resistin were determined. Result： Blood pressure, leptin and resistin were higher, FMD and adiponectin were lower in hypertensive patients than those in control group （all P^0.05）. After 12 weeks treatment of losartan, compared with those before treatment, blood pressure reduced, FMD and adiponectin increased, leptin and resistin decreased significantly in hypertensive patients （all P〈0.05）. Pearson correlation analysis showed that FMD was negatively correlated with SBP （r=-0.66）, TC （r=-0.53）, leptin （r= --0.60）, resistin （r=--0.55）, and positively correlated with adiponectin （r=0. 73） （all P〈0.05）. Multi- ple linear stepwise regression analysis showed that adiponectin, leptin and resistin were the impact factors of FMD （all P〈0. 05）. ConclusionLosartan improving vascular endothelial function may be associated with improving the metabolism of adipocyte factors in hypertensive patients.

关 键 词：高血压 氯沙坦 血管内皮功能 脂联素 瘦素 抵抗素 

分 类 号：R544.1[医药卫生—心血管疾病]