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目的比较替米沙坦/氢氯噻嗪片和氯沙坦钾/氢氯噻嗪片对高血压患者的降压疗效和对血管内皮功能的影响。方法将2004年9月至2006年5月安徽医科大学第一附属医院收治的61例高血压患者随机分为替米沙坦/氢氯噻嗪组31例和氯沙坦钾/氢氯噻嗪组30例,治疗8周。统计治疗后的血压控制率和测定治疗8周前后血清肝细胞生长因子(HGF)、血清一氧化氮(NO)和血浆内皮素(ET)水平。结果(1)治疗8周后两组收缩压(SBP)、舒张压(DBP)均明显下降(P均<0.01),但两组间治疗前、治疗2周、4周、8周的SBP、DBP和血压控制率差异无统计学意义(P均>0.05);(2)与正常对照者相比高血压患者血清HGF、血浆ET明显增高,血清NO明显降低(P均<0.01),治疗8周后两组血清HGF、血浆ET明显下降,血清NO明显升高(P均<0.01),两组血清HGF下降幅度(△HGF)、血清NO升高幅度(△NO)差异无统计学意义(P均>0.05),而血浆ET下降幅度(△ET)、△ET/△NO比值差异有统计学意义(P均<0.01)。结论(1)治疗8周两药降压效果相似;(2)两药都能逆转血管内皮功能不全,但替米沙坦/氢氯噻嗪片可能强于氯沙坦钾/氢氯噻嗪片。
Objective To compare the effects of telmisartan / hydrochlorothiazide and losartan potassium / hydrochlorothiazide on the antihypertensive effect and the vascular endothelial function in hypertensive patients. Methods From September 2004 to May 2006, 61 hypertensive patients admitted to the First Affiliated Hospital of Anhui Medical University were randomly divided into telmisartan / hydrochlorothiazide group (31 cases) and losartan potassium / hydrochlorothiazide group (30 cases), treatment group 8 week. The rate of blood pressure control after treatment and the levels of serum hepatocyte growth factor (HGF), serum nitric oxide (NO) and plasma endothelin (ET) were measured before and 8 weeks after treatment. Results (1) SBP and DBP decreased significantly in both groups after 8 weeks of treatment (all P <0.01). However, the SBP, SBP and DBP of two groups before treatment, two weeks, four weeks, (P> 0.05). (2) The levels of serum HGF, ET and plasma ET in hypertensive patients were significantly higher than those in normal controls (P <0.01) The levels of HGF, ET and plasma NO in the two groups were significantly lower than those in the control group (P <0.01). There was no significant difference between the two groups in serum HGF decline (△ HGF) and serum NO increase (△ NO) P> 0.05). However, there was a significant difference in the decrease of plasma ET, △ ET / △ NO between the two groups (all P <0.01). Conclusions (1) The antihypertensive effects of two drugs for 8 weeks are similar; (2) Both drugs can reverse the vascular endothelial dysfunction, but telmisartan / hydrochlorothiazide tablets may be stronger than losartan potassium / hydrochlorothiazide tablets.