替米沙坦对冠心病合并高血压患者血管内皮功能及炎症因子的影响  

Effect of Telmisartan on vascular endothelial function and inflammatory factors of patients with coronary heart disease and hypertension

作　　者：兰行远[1] 徐尚华[1] 

机构地区：[1]福建省南平市第二医院心内科,福建南平354200

出　　处：《中国医药导报》2015年第33期142-145,150,共5页China Medical Herald

基　　金：福建省卫生厅医学创新课题(2011-CX-35)

摘　　要：目的 探讨替米沙坦对冠心病合并高血压患者血管内皮功能及炎症因子的影响。方法 选取2012年3月~2014年3月南平市第二医院心内科收治的冠心病合并高血压患者204例,按随机数字表法将其分为A、B、C组,各68例。在冠心病常规治疗的基础上,三组给予不同类型降压药控制血压,A组给予替米沙坦80 mg口服,1次/d;B组给予贝那普利10 mg口服,1次/d;C组给予硝苯地平缓释片10 mg口服,1次/d,均持续6个月。治疗前、治疗6个月后观察血压、血清内皮素-1（ET-1）、血清一氧化氮（NO）、高敏C反应蛋白（hs-CRP）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平,颈动脉彩超监测颈动脉内膜中层厚度（IMT）。结果 治疗6个月后三组SBP、DBP均较治疗前明显下降（P〈0.05）,但组间差异无统计学意义（P〉0.05）。A组IMT较治疗前明显降低（P〈0.05）,B、C组IMT与治疗前比较差异无统计学意义（P〉0.05）,三组治疗6个月后IMT组间差异有统计学意义（P〈0.05）,A组IMT明显低于B、C组（P〈0.05）。治疗6个月后三组ET-1、NO与治疗前比较及组间比较,差异均有统计学意义（P〈0.05）,A组ET-1明显低于B、C组（P〈0.05）,A组NO明显高于B、C组（P〈0.05）。治疗6个月后三组TNF-α、IL-6、hs-CRP差异均有统计学意义（P〈0.05）,A组TNF-α、IL-6、hs-CRP明显低于B、C组（P〈0.05）。结论 替米沙坦治疗冠心病合并高血压可以有效控制患者血压,并具有降低患者颈动脉IMT、改善内皮功能和抗感染作用。Objective To investigate the effect of Telmisartan on vascular endothelial function and inflammatory factors of patients with coronary heart disease and hypertension. Methods Two hundred and four eases of patients with coro- nary heart disease and hypertension admitted to Department of Cardiology of the Second Hospital of Nanping City from March 2012 to March 2014 were selected, and they were divided into group A, B, C accorded to random number table, with 68 cases in each group. On basis of conventional therapy of coronary heart disease, the three groups were given different types of antihypertensive drugs to control blood pressure, group A was given Telmisartan 80 mg orally, once a day; group B received Benazepril 10 mg orally, once a day; group C was administered Nifedipine Sustained Release Tablets 10 mg orally, once a day, all for 6 months. The levels of blood pressure, serum endothelin-1 （ET-1）, nitric ox- ide （NO）, high-sensitivity C-reactive protein （hs-CRP）, interleukin -6 （IL-6）, tumor necrosis factor-or （TNF-α） before treatment and after treatment for six months were observed. The carotid color ultrasonography was used to monitor the carotid intima media thickness （IMT）. Results After treatment for 6 months, SBP and DBP in the three groups were all decreased significantly （P 〈 0.05）, while there were no statistically significant differences among the three groups （P 〉 0.05）. IMT of group A was significantly decreased compared with before treatment （P 〈 0.05）, there were no statistically significant differences of IMT in group B and C compared with before treatment （P 〉 0.05）, there was statistically sig- nificant difference of IMT after treatment for 6 months among the three groups （P 〈 0.05）, the IMT of group A was sig- nificantly lower than those of group B, C （P 〈 0.05）. After treatment for 6 months, ET-1 and NO in the three groups had statistically significant differences compared with before treatment and there were statistically signifi

关 键 词：替米沙坦 血管内皮功能 炎症因子 冠心病 高血压 

分 类 号：R541.5[医药卫生—心血管疾病] R544.1[医药卫生—内科学]