不同药物降压对高血压患者血管重构的影响-现代医学

不同药物降压对高血压患者血管重构的影响

单位：邳州市人民医院

分类号：

出版年·卷·期（页码）：2014·42·第三期（265-269）

摘要：

目的通过门诊体检筛查1-2级高血压病人，有效降压的基础上，比较不同降压药物对血管重构影响的差异性。方法将入选200例患者随机分成四组，根据所选择降压药物分为ACEI组、ARB组、CCB组、β受体阻滞剂组，每组50例病人，并设立非高血压对照组，分别测量24小时动态血压、双侧颈总动脉IMT、PWV、桡动脉壁腔比、CRP，比较四类降压药物在降压达标后对血管重构影响的差异性。结果 ①4组高血压患者IMT、PWV与正常对照组比较明显增大（P<0.05），经过有效的降压治疗较前降低（P<0.05），以ACEI及ARB组明显，但各组之间无明显统计学意义（P>0.05）；②4组高血压患者桡动脉壁腔比与正常对照组比较明显增大，经过有效的降压治疗较前降低（P<0.05），各组之间无明显统计学意义（P>0.05）；③4组高血压患者中CPR水平较正常对照组均升高，在降压达标后，CPR逐渐恢复降低，各组之间无明显统计学差异（P>0.05）。结论高血压患者双侧颈总动脉IMT、PWV、桡动脉壁腔比、CRP均较非高血压正常人群升高，经过有效降压治疗，血管重构指标均有不同程度好转，以ARB组及ACEI组明显，但各组之间无明显统计学差异，值得进一步观察及研究。

Objective: To compare the impact on vascular remodeling of four different hypertension-lowering drugs based on effective hypertension-control among out-door patients. Methods: Two hundred hypertensive patients were divided into four groups treated with ACEI, ARB, CCB or β-blockers respectively (n=50 in each group). 50 subjects were enrolled as controls. 24-hour blood pressure monitor, carotid IMT, PWV, radial artery wall/luminal ratio, CRP were collected and analyzed among five groups. Results: Average IMT, PWV, radial artery wall/luminal ratio and CRP in hypertensive patients were higher than that in controls, and decreased significantly after effective treatment (all P<0.05), without difference among four hypertensive groups (P>0.05). Conclusion: Hypertensive patients had higher values of average IMT, PWV, radial artery wall/luminal ratio and CRP compared with that in controls and the markers of vascular remodeling showed improvement after effective hypertension-therapy.

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