氯沙坦、福辛普利和硝苯地平控释剂对原发性高血压患者血管内皮功能的保护作用

摘要

为评价和比较氯沙坦、福辛普利和硝苯地平控释剂对原发性高血压(简称高血压病)患者血管内皮功能的保护作用，分别应用以上3种药物对轻中度高血压病患者进行治疗，并与对照组比较。应用放射免疫分析法、酶法及酶联免疫吸附法观察比较治疗前及治疗4周末对血管内皮功能的影响。结果发现高血压病患者血浆内皮素(ET)、血小板α-颗粒膜蛋白(GMP140)、血管性假血友病因子抗原(vWF)显著高于正常对照组(P＜0.05，P＜0.01)，一氧化氮(NO)与对照组相比无显著性差异，但NO/ET显著低于对照组(P＜0.05)。3种药物治疗4周后，血浆ET、vWF均较治疗前显著降低(P＜0.05，P＜0.01)，但vWF仍高于正常对照组(P＜0.05)；血浆NO及NO/ET较治疗前及正常对照组显著升高(P＜0.05，P＜0.01)；与氯沙坦和福辛普利组相比，硝苯地平控释剂组血浆GMP140治疗后显著降低(P＜0.05)。提示以上3种药均能有效改善高血压病早期的血管内皮功能损害，硝苯地平控释剂对GMP140的改善作用优于氯沙坦组和福辛普利组。%For investigating and comparing the effects of fosinopril, losartan and nifedipine GITS on protective functions for endothelium in patients with essential hypertension (EH), patients with mild to moderate EH and healthy controls were studied. Patients with EH were randomly divided into three groups and were treated with Nifedipine GITS, Fosinopril or Losartan separately. The plasma levels of ET, NO, GMP140, vWF were compared before and after 4-week treatment. Plasma levels of ET, NO, vWF, GMP140 were measured with radioimmunoassay, enzymatic assay or ELISA as indexes of endothelial functions. The results showed that the antihypertensive effects of three medicines had no statistical differences. Plasma levels of ET, GMP140, vWF were significantly higher and the NO/ET was lower in EH patients than those in controls. Plasma levels of ET and vWF were decreased and the levels of NO and NO/ET were increased deeply at the end of 4-week treatment (P＜0.05,P＜0.01). Plasma level of GMP140 in group N was declined significantly (P＜0.05). It is suggested that all three antihypertensive drugs can significantly and safely decrease blood pressure, and protect vessel endothelial function in early stage of hypertension. Nifedipine GITS is better than others in GMP140, Losartan is better than others in drug tolerance.