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目的探讨高血压病患者正常血清胆红素水平内不同胆红素水平与动脉弹性及左室肥厚(LVH)的关系,以及长期服用氨氯地平的疗效。方法以全自动生化分析仪测定79例高血压病患者血清胆红素水平,利用动脉弹性功能测定仪检测动脉弹性,利用超声心动图(UCG)检测左室质量指数(LV-MI),按照血清总胆红素(TBil)水平将79例患者分为两组,即低血清胆红素水平组,A组,48例;高血清胆红素水平组,B组,31例。患者连续服用氨氯地平36个月,比较两组动脉弹性和LVMI的变化。结果79例患者血清TBil水平均在正常范围内,A、B两组TBil分别为(7.8±1.8)μmol/L和(14.3±1.7)μmol/L,两组TBil比较,(P<0.01)。服用氨氯地平8周后血压能控制在140/90mmHg以下且保持平稳。A组治疗前小动脉弹性指数(C2)明显低于B组(P<0.05),治疗后两组C2逐渐增加,A组在治疗24个月时即出现显著改善,两组均在治疗36个月时较治疗前有显著增加;治疗前A组LVMI高于B组,但无显著统计学意义,治疗后为两组LVMI逐渐降低,A组治疗前与治疗36个月后比较,P<0.05,B组治疗前后LVMI比较无显著统计学意义。结论血清胆红素水平与血管损伤呈反相关。钙通道阻滞剂氨氯地平在平稳降压的同时,能恢复受损的动脉血管弹性,改善血管功能,减轻LVH。
Objective To investigate the relationship between different bilirubin levels and arterial elasticity and left ventricular hypertrophy (LVH) in normal serum bilirubin level in patients with essential hypertension and the effect of long-term amlodipine. Methods Serum bilirubin levels were measured in 79 patients with essential hypertension by automatic biochemical analyzer. Arterial elasticity was measured by arterial elasticity test. Left ventricular mass index (LV-MI) was measured by echocardiography (UCG) Serum total bilirubin (TBil) levels of 79 patients were divided into two groups, namely low serum bilirubin level group A, 48 cases; high serum bilirubin level group B, 31 cases. Patients taking amlodipine for 36 months continuously, the changes of arterial elasticity and LVMI in both groups were compared. Results The serum levels of TBil in 79 patients were all in the normal range. The TBil in groups A and B were (7.8 ± 1.8) μmol / L and (14.3 ± 1.7) μmol / L, respectively. After taking amlodipine 8 weeks after the blood pressure can be controlled below 140 / 90mmHg and remain stable. The arterial elasticity index (C2) in group A before treatment was significantly lower than that in group B (P <0.05), C2 increased gradually after treatment in group A, and significantly improved in group A at 24 months after treatment Month before treatment was significantly increased; before treatment, LVMI in group A was higher than that in group B, but there was no statistical significance. After treatment, LVMI gradually decreased in group A and group P before treatment and after 36 months There was no significant difference in LVMI between group B before and after treatment. Conclusion Serum bilirubin level is inversely related to vascular injury. Amlodipine, a calcium channel blocker, can restore damaged arterial elasticity, improve vascular function and relieve LVH while stabilizing blood pressure.