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目的 探讨氯沙坦治疗前后高血压患者血管内皮功能和血浆血管紧张素Ⅱ的变化。 方法 5 0例高血压患者氯沙坦治疗 4～ 6周 ,根据达目标血压 (以舒张压 <90mmHg为标准调整降压药每天剂量 5 0～ 10 0mg ,部分患者加双氢氯噻嗪 2 5mg) ,观察氯沙坦治疗前后肱动脉超声检测血管内皮功能和血浆血管紧张素Ⅱ浓度的变化。 结果 肱动脉内径基础值及含服硝酸甘油后肱动脉内径变化差异均无显著性〔(3 78± 0 5 7)mm对 (3 82± 0 6 3)mm ,(18 7± 4 5 ) %对 (2 0 1± 7 2 ) % ,P >0 0 5〕 ,反应性血管充血引起肱动脉内径的变化治疗前后差异有显著性〔(4 32± 0 71) %对(9 38± 4 1) % ,P <0 0 1)〕。氯沙坦治疗前后血浆血管紧张素Ⅱ浓度变化显著〔(38 6± 6 8)pmol/L对 (76 9± 15 3)pmol/L ,P <0 0 1〕。 结论 氯沙坦在有效降压的同时 ,能改善血管内皮舒张功能。
Objective To investigate the changes of vascular endothelial function and plasma angiotensin Ⅱ in patients with hypertension before and after losartan treatment. Methods Fifty patients with hypertension were treated with losartan for 4 to 6 weeks. According to the target blood pressure (the daily dose of hypotensive drug was 50 ~ 100 mg, and some patients were treated with hydrochlorothiazide 25 mg at diastolic blood pressure <90 mmHg) Changes of vascular endothelial function and plasma concentration of angiotensin Ⅱ in brachial artery before and after losartan treatment. Results There was no significant difference in the brachial artery internal diameter and brachial artery internal diameter after taking nitroglycerin (3 78 ± 0 5 7) mm vs (3 82 ± 0 6 3) mm, (18 7 ± 45)%, (2 0 1 ± 7 2)%, P 0 05). There was significant difference in the diameter of the brachial artery caused by reactive vascular congestion before and after treatment [(4 32 ± 0 71)% vs (9 38 ± 4 1 )%, P <0 0 1)]. The changes of plasma angiotensin Ⅱ before and after losartan treatment were significantly (38 6 ± 6 8) pmol / L vs. (76 9 ± 15 3) pmol / L, P 0 01). Conclusion Losartan can effectively decrease the diastolic function of vascular endothelial cells while lowering blood pressure effectively.