厄贝沙坦氢氯噻嗪对高血压患者血管内皮功能、血流动力学及炎症反应的影响
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摘要
目的:观察厄贝沙坦氢氯噻嗪对高血压患者血管内皮功能、血流动力学及炎症反应的影响。方法:选择就诊于我院的原发性高血压患者100例为研究对象,根据随机数字表法分为对照组和观察组。对照组50例行常规治疗,观察组50例在此常规治疗基础上口服厄贝沙坦氢氯噻嗪治疗。比较两组血管内皮功能、血流动力学及炎症因子水平的变化。结果:治疗前,两组vWF、EDD、NMD水平,血液流变学水平以及炎性因子水平比较差异无统计学意义(P>0.05)。与治疗前相比,治疗后观察组vWF水平明显降低、EDD水平明显升高(P<0.05),NMD水平无明显变化(P>0.05);而对照组vWF水平明显降低(P<0.05),EDD、NMD水平无明显变化(P>0.05)。治疗后,观察组vWF水平明显低于对照组vWF水平,EDD水平明显高于对照组EDD水平,差异对比均有显著性(P<0.05)。治疗后,观察组LBV、HBV、PV水平较治疗前均显著降低(P<0.05),而对照组LBV、HBV、PV水平与治疗前相比差异不显著(P>0.05)。治疗后,观察组LBV、HBV、PV水平均显著低于对照组相应水平(P<0.05)。治疗后,两组CRP、ICAM-1、MCP-1水平较治疗前均显著降低(P<0.05)。治疗后,观察组CRP、ICAM-1、MCP-1水平均明显低于对照组相应水平,差异有统计学意义(P<0.05)。结论:厄贝沙坦氢氯噻嗪治疗高血压可对患者血管内皮功能、血液流变学水平起到明显的改善作用,且能显著降低机体炎症反应,值得临床推广应用。
Objective:To observe the effect of irbesartan hydrochloride on endothelial function,hemodynamics and inflammatory response in patients with essential hypertension.Method:A total of 100 patients with essential hypertension admitted from May 2015 to August 2017 in our hospital were divided into observation group(n=50)and control group(n=50)according to random number table.Thecontrol group was treated with routine treatment,and the observation group was treated with erbesartan hydrochlorothiazide on the basis of routine treatment in the control group.The changes of vascular endothelial function,hemodynamics and inflammatory factors in the two groups were compared.Results:Before treatment,there was no significant difference invWF,EDD and NMD levels,hemodynamicslevel and CRP,ICAM-1 and MCP-1 levels(P>0.05).After treatment,the vWF levelin the observation group was significantly decreased and the EDD level was significantly increased(P<0.05);while the level of NMD was not significantly changed(P>0.05).After treatment,the level of vWF in the control group was significantly decreased(P<0.05);but there was no significant change in EDD and NMD level(P>0.05).After treatment,vWFlevel(144.94±16.21)%in the observation group was significantly lower than that in the control group;EDD level(6.81±0.74)% was significantly higher than that in the control group(P<0.05).After treatment,the levels of LBV,HBV and PV in the observation group were significantly lower than those before treatment(P<0.05),while the levels of LBV,HBV and PV in the control group were not significantly different from those before treatment(P>0.05).After treatment,LBV level(13.34±1.41)m·pas,HBV level(5.13±1.34)m·pas and PV level(1.65±0.34)m·pas in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of CRP,ICAM-1 and MCP-1 in both groups were significantly lower than those before treatment(P<0.05).After treatment,the level of CRP(1.71±0.81)mg/L,ICAM-1 level(330.82±68.51)ng/mL and MCP-1 level(3.02±1.06)g/L in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Irbesartan hydrochlorothiazide treatment of hypertension can play a significant role in the improvement of vascular endothelial function and hemorheology in patients,and can significantly reduce the level of inflammatory response in the body,worthy of clinical application.
Objective:To observe the effect of irbesartan hydrochloride on endothelial function,hemodynamics and inflammatory response in patients with essential hypertension.Method:A total of 100 patients with essential hypertension admitted from May 2015 to August 2017 in our hospital were divided into observation group(n=50)and control group(n=50)according to random number table.Thecontrol group was treated with routine treatment,and the observation group was treated with erbesartan hydrochlorothiazide on the basis of routine treatment in the control group.The changes of vascular endothelial function,hemodynamics and inflammatory factors in the two groups were compared.Results:Before treatment,there was no significant difference invWF,EDD and NMD levels,hemodynamicslevel and CRP,ICAM-1 and MCP-1 levels(P>0.05).After treatment,the vWF levelin the observation group was significantly decreased and the EDD level was significantly increased(P<0.05);while the level of NMD was not significantly changed(P>0.05).After treatment,the level of vWF in the control group was significantly decreased(P<0.05);but there was no significant change in EDD and NMD level(P>0.05).After treatment,vWFlevel(144.94±16.21)%in the observation group was significantly lower than that in the control group;EDD level(6.81±0.74)% was significantly higher than that in the control group(P<0.05).After treatment,the levels of LBV,HBV and PV in the observation group were significantly lower than those before treatment(P<0.05),while the levels of LBV,HBV and PV in the control group were not significantly different from those before treatment(P>0.05).After treatment,LBV level(13.34±1.41)m·pas,HBV level(5.13±1.34)m·pas and PV level(1.65±0.34)m·pas in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of CRP,ICAM-1 and MCP-1 in both groups were significantly lower than those before treatment(P<0.05).After treatment,the level of CRP(1.71±0.81)mg/L,ICAM-1 level(330.82±68.51)ng/mL and MCP-1 level(3.02±1.06)g/L in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Irbesartan hydrochlorothiazide treatment of hypertension can play a significant role in the improvement of vascular endothelial function and hemorheology in patients,and can significantly reduce the level of inflammatory response in the body,worthy of clinical application.
引文
1苏海燕,雷兆军,李洁,等.病情控制状况对原发性高血压冠脉血流储备影响的研究[J].湖南师范大学学报(医学版),2017,14(4):113-116.
2 白梅,李建武,蔡江涛,等.老年原发性高血压患者颈内动脉系和椎-基底动脉系颅内外血管血流动力学变化[J].实用老年医学,2016,30(7):574-577.
3 Ali TA,Mohamed GG,Aglan AA,et al.RP-HPLC Stabilityindicating Method for Estimation of Irbesartan and Hydrochlorothiazide in Bulk and Pharmaceutical Dosage Form[J].Chinese Journal of Analytical Chemistry,2016,44(1):e1601-e1608.
4 石俊杰.厄贝沙坦联合氨氯地平或氢氯噻嗪治疗老年性高血压病临床疗效分析[J].海南医学院学报,2014,20(2):188-190+194.
5 卫生部疾病预防控制局.中国高血压防治指南[M].人民卫生出版社,2009.
6 武颖,衷敬柏.105例青年原发性高血压临床特点与疗效分析[J].北京中医药,2017,36(3):213-216.
7 袁坚宾.原发性高血压患者血清同型半胱氨酸含量与颈动脉粥样硬化、左心室舒张功能的相关性[J].海南医学院学报,2016,22(23):2804-2807.
8 蔡文花,李丽敏,王雪敏,等.原发性高血压患者动脉硬化指数与颈动脉粥样硬化的相关性[J].海南医学院学报,2016,22(8):751 -753+757.
9 张颖,张磊,高宪玺.养心汤对急性心肌梗死PCI术后炎症反应及血管内皮功能的影响[J].湖南师范大学学报(医学版),2017,14(3):112-115.
10 Ali TA,Mohamed GG,Aglan AA,et al.RP-HPLC Stabilityindicating Method for Estimation of Irbesartan and Hydrochlorothiazide in Bulk and Pharmaceutical Dosage Form[J].Chinese Journal of Analytical Chemistry,2016,44(1):e1601-e1608.
11 Yu H,Nakagawa T,Uekawa K,et al.Therapy with the Combination of Amlodipine and Irbesartan Has Persistent Preventative Effects on Stroke Onset Associated with BDNF Preservation on Cerebral Vessels in Hypertensive Rats[J].Translational Stroke Research,2016,7(1):79-87.
12 Enrico AR,Athanasios M,Dario Z,et al.Zofenopril Plus Hydrochlorothiazide and Irbesartan Plus Hydrochlorothiazide in Previously Treated and Uncontrolled Diabetic and Non-diabetic Essential Hypertensive Patients[J].Advances in Therapy,2014,31(2):217-233.
13 De DM,Soto J,Mennickent S.Stability-indicating LC method for the simultaneous determination of lisinopril and hydrochlorothiazide.[J].Journal of Chromatographic Science,2014,52(10):1193.
14 张玲,张蕾.阿托伐他汀对高血压患者血清炎性因子、血管内皮功能及血脂水平的影响[J].海南医学院学报,2015,21(7):905-907 +910.
15 罗君华.血管内皮生长因子及富含半胱氨酸蛋白61与高血压颈动脉粥样硬化的关系[J].海南医学院学报,2013,19(9):1242-1245.
16 邢芸芸,李欣.钙离子拮抗剂与血管紧张素受体拮抗剂对血压晨峰现象影响的临床对照研究[J].实用药物与临床,2015,18(2):231-235.
17 Lynch CJ,Lane DA.N-linked glycan stabilization of the VWF A2domain[J].Blood,2016,127(13):1711.
18 蒋明争,李琼,刘会.辛伐他汀联合苯磺酸氨氯地平对老年高血压合并高血脂症患者血液流变学、血小板活化的影响[J].海南医学院学报,2016,22(17):1958-1961.
19 Mazidi M,Rezaie P,Ferns GA,et al.Impact of different types of tree nut,peanut,and soy nut consumption on serum C-reactive protein(CRP):A systematic review and meta-analysis of randomized controlled clinical trials[J].Medicine,2016,95(44):e5165.
20 Yoshio T,Okamoto H,Kurasawa K,et al.IL-6,IL-8,IP-10,MCP-1and G-CSF are significantly increased in cerebrospinal fluid but not in sera of patients with central neuropsychiatric lupus erythematosus[J].Lupus,2016,25(9):997.
21 Ng WL,Marinov GK,Liau ES,et al.Inducible RasGEF1Bcircular RNA is a positive regulator of ICAM-1in the TLR4/LPS pathway[J].Rna Biology,2016,13(9):861-871.
2 白梅,李建武,蔡江涛,等.老年原发性高血压患者颈内动脉系和椎-基底动脉系颅内外血管血流动力学变化[J].实用老年医学,2016,30(7):574-577.
3 Ali TA,Mohamed GG,Aglan AA,et al.RP-HPLC Stabilityindicating Method for Estimation of Irbesartan and Hydrochlorothiazide in Bulk and Pharmaceutical Dosage Form[J].Chinese Journal of Analytical Chemistry,2016,44(1):e1601-e1608.
4 石俊杰.厄贝沙坦联合氨氯地平或氢氯噻嗪治疗老年性高血压病临床疗效分析[J].海南医学院学报,2014,20(2):188-190+194.
5 卫生部疾病预防控制局.中国高血压防治指南[M].人民卫生出版社,2009.
6 武颖,衷敬柏.105例青年原发性高血压临床特点与疗效分析[J].北京中医药,2017,36(3):213-216.
7 袁坚宾.原发性高血压患者血清同型半胱氨酸含量与颈动脉粥样硬化、左心室舒张功能的相关性[J].海南医学院学报,2016,22(23):2804-2807.
8 蔡文花,李丽敏,王雪敏,等.原发性高血压患者动脉硬化指数与颈动脉粥样硬化的相关性[J].海南医学院学报,2016,22(8):751 -753+757.
9 张颖,张磊,高宪玺.养心汤对急性心肌梗死PCI术后炎症反应及血管内皮功能的影响[J].湖南师范大学学报(医学版),2017,14(3):112-115.
10 Ali TA,Mohamed GG,Aglan AA,et al.RP-HPLC Stabilityindicating Method for Estimation of Irbesartan and Hydrochlorothiazide in Bulk and Pharmaceutical Dosage Form[J].Chinese Journal of Analytical Chemistry,2016,44(1):e1601-e1608.
11 Yu H,Nakagawa T,Uekawa K,et al.Therapy with the Combination of Amlodipine and Irbesartan Has Persistent Preventative Effects on Stroke Onset Associated with BDNF Preservation on Cerebral Vessels in Hypertensive Rats[J].Translational Stroke Research,2016,7(1):79-87.
12 Enrico AR,Athanasios M,Dario Z,et al.Zofenopril Plus Hydrochlorothiazide and Irbesartan Plus Hydrochlorothiazide in Previously Treated and Uncontrolled Diabetic and Non-diabetic Essential Hypertensive Patients[J].Advances in Therapy,2014,31(2):217-233.
13 De DM,Soto J,Mennickent S.Stability-indicating LC method for the simultaneous determination of lisinopril and hydrochlorothiazide.[J].Journal of Chromatographic Science,2014,52(10):1193.
14 张玲,张蕾.阿托伐他汀对高血压患者血清炎性因子、血管内皮功能及血脂水平的影响[J].海南医学院学报,2015,21(7):905-907 +910.
15 罗君华.血管内皮生长因子及富含半胱氨酸蛋白61与高血压颈动脉粥样硬化的关系[J].海南医学院学报,2013,19(9):1242-1245.
16 邢芸芸,李欣.钙离子拮抗剂与血管紧张素受体拮抗剂对血压晨峰现象影响的临床对照研究[J].实用药物与临床,2015,18(2):231-235.
17 Lynch CJ,Lane DA.N-linked glycan stabilization of the VWF A2domain[J].Blood,2016,127(13):1711.
18 蒋明争,李琼,刘会.辛伐他汀联合苯磺酸氨氯地平对老年高血压合并高血脂症患者血液流变学、血小板活化的影响[J].海南医学院学报,2016,22(17):1958-1961.
19 Mazidi M,Rezaie P,Ferns GA,et al.Impact of different types of tree nut,peanut,and soy nut consumption on serum C-reactive protein(CRP):A systematic review and meta-analysis of randomized controlled clinical trials[J].Medicine,2016,95(44):e5165.
20 Yoshio T,Okamoto H,Kurasawa K,et al.IL-6,IL-8,IP-10,MCP-1and G-CSF are significantly increased in cerebrospinal fluid but not in sera of patients with central neuropsychiatric lupus erythematosus[J].Lupus,2016,25(9):997.
21 Ng WL,Marinov GK,Liau ES,et al.Inducible RasGEF1Bcircular RNA is a positive regulator of ICAM-1in the TLR4/LPS pathway[J].Rna Biology,2016,13(9):861-871.