奥美沙坦对高血压合并冠心病和糖尿病患者血管内皮功能的保护作用

发布时间：2018-07-06 19:16

本文选题：奥美沙坦 + 高血压　；参考：《中国动脉硬化杂志》2017年02期

【摘要】：目的通过检测奥美沙坦用药前后患者血管内皮功能的变化,探讨奥美沙坦对于高血压病合并冠心病和糖尿病患者血管内皮功能的保护作用。方法收集符合条件的高血压患者160例,根据是否合并冠心病和糖尿病分为3组:单纯高血压组(H组,n=40)、高血压合并冠心病组(HC组,n=62)、高血压合并冠心病和糖尿病组(HCD组,n=58),然后再将各组平均分为2个亚组:奥美沙坦干预亚组(A亚组)、非奥美沙坦干预亚组(B亚组)。统计各组基线资料及一般检查指标,用酶联免疫吸附试验检测血清一氧化氮和内皮素1的浓度,并用流式细胞术检测外周血内皮祖细胞(EPC)数量;奥美沙坦干预3个月后复查。结果 (1)血管内皮舒缩因子:用药前,与H组比较,HC组、HCD组的一氧化氮浓度均明显降低,而内皮素1浓度均明显升高,且HCD组变化更明显(P0.05);用药后,与用药前比较,HC-A亚组、HCD-A亚组的一氧化氮浓度均明显升高,而内皮素1浓度均降低(P0.05)。(2)外周血EPC数量:用药前,与H组比较,HC组、HCD组的外周血EPC数量均减少,且HCD组减少更明显(P0.05);用药后,与用药前比较,HC-A亚组、HCD-A亚组的EPC数量升高(P0.05)。结论高血压患者合并冠心病和糖尿病时会加重血管内皮的损害。奥美沙坦可以抑制血管内皮舒缩因子失衡,并提高外周血EPC数量,具有血管内皮保护作用。
[Abstract]:Objective to investigate the protective effect of omesartan on vascular endothelial function in hypertensive patients with coronary heart disease (CHD) and diabetes mellitus (DM). Methods 160 patients with hypertension were collected. They were divided into three groups according to whether they were complicated with coronary heart disease and diabetes: simple hypertension group (H group), hypertension combined with coronary heart disease group (HC group) and hypertension with coronary heart disease and diabetes group (HCD group). Then each group was divided into two subgroups on average. Omesartan intervention subgroup (subgroup A), non-olmesartan intervention subgroup (subgroup B). The serum levels of nitric oxide and endothelin 1 were measured by enzyme linked immunosorbent assay (Elisa) and the number of peripheral blood endothelial progenitor cells (EPC) were detected by flow cytometry. Results (1) Endothelial systolic and diastolic factor: compared with H group, the concentration of nitric oxide in HCD group decreased significantly, while endothelin 1 concentration increased significantly in HCD group, especially in HCD group (P0.05). The concentration of nitric oxide in HCD-A subgroup was significantly higher than that before treatment, while the concentration of endothelin-1 decreased (P0.05) in peripheral blood (P0.05). The number of EPCs in peripheral blood of HCD-A subgroup was lower than that of H group, and that of HCD-A subgroup was lower than that of H group, and the concentration of endothelin-1 in HCD-A subgroup was significantly lower than that in H group. The number of EPC in HC-A subgroup was significantly higher than that in HC-A subgroup (P0.05). Conclusion Hypertension patients with coronary heart disease and diabetes will aggravate the damage of vascular endothelium. Omesartan can inhibit vascular endothelial systolic and diastolic factor imbalance and increase the number of peripheral blood EPC.
【作者单位】：济南军区总医院心内科;泰山医学院;
【基金】：北京力生心血管健康基金会领航基金项目(LHJJ20143325)
【分类号】：R544.1;R541.4;R587.2

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