硝苯地平控释片改善血管内皮功能的探讨  

Possible Mechanism of Nifedipine-GITS in the Improvement of Vascular Endothelial Function

作　　者：胡雪松[1] 孙宁玲[2] 

机构地区：[1]深圳市第二人民医院心内科,广东省518035 [2]北京大学人民医院心内科

出　　处：《中国循环杂志》2002年第3期209-211,共3页Chinese Circulation Journal

摘　　要：目的 :通过对原发性高血压患者的肱动脉超声及血管肽的测定探讨硝苯地平控释片 (拜新同 )改善内皮功能的机制。方法 :将 40例原发性高血压患者分为硝苯地平控释片组 (n =2 0 )及美托洛尔组 (n =2 0 )进行比较 ,均治疗 8周 ,并将 2 0例正常健康人作为对照 (正常对照组 )。采用肱动脉超声的方法进行血管内皮依赖性舒张功能的判断及放射免疫分析法进行治疗前、后的血管活性肽肾上腺髓质素 (ADM )、一氧化氮 (NO)、内皮素 1(ET 1)及血管紧张素Ⅱ (AngⅡ )的测定。结果 :①两组药物治疗后与治疗前比较血压均明显降低 ,有非常显著性差异 (P <0 .0 1)。②硝苯地平控释片组治疗后发现血流介导的肱动脉内径扩张率增加 11.2 % ,肱动脉血流速度增加 18.4ml/min ,血浆ADM、NO明显增加 ,AngⅡ降低 ,与治疗前比较均有显著性差异 (P <0 .0 5 ) ,而美托洛尔组无此变化。结论 :硝苯地平控释片可能通过促进血管内皮细胞对ADM的分泌及释放 ,介导了NO浓度的增高 ,从而改善了原发性高血压患者的内皮功能。Objective:To find the possible mechanism of nifedipine GITS in improving vascular endothelium dependent vasodilation function. Methods:Twenty hypertensive patients received 8 weeks of nifedipine GITS treatment.Another group of 20 patients received metoprolol.The results of the two groups were compared.Twenty healthy people served as controls.The systolic function of vascular endothelium was evaluated by brachial artery ultrasounography.At the same time,the plasma vasoactive peptide adrenomedullin (ADM),endothelin 1 (ET 1) and angiotensin Ⅱ (Ang Ⅱ) were tested by radioimmunoassay,and the plasma concentration of nitric oxide(NO) by spectrophotography. Results:①Both medicines significantly decreased blood pressure( p <0.01).②In the nifedipine GITS group,the blood flow mediated brachial artery distensibility increased about 11.2%.The velocity of blood flow in brachial artery was increased by 18.4 ml/min.The plasma levels of ADM and NO significantly increased,but Ang Ⅱ significantly decreased.Metoprolol did not induce the above changes. Conclusion:Nifedipine GITS can stimulate the release of ADM from vascular endothelium and vascular smooth muscle cells and induce the increase of plasma concentration of NO,thus improving the endothelial function.

关 键 词：硝苯地平控释片 血管内皮功能 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]