贝那普利对2型糖尿病并发高血压患者内皮功能不全的血浆生物指标的影响.DOCVIP

临床医学论文-贝那普利对2型糖尿病并发高血压患者内皮功能不全的血浆生物指标的影响 【关键词】? 贝那普利；2型糖尿病；血栓调节蛋白；一氧化氮；vW因子 ??? ［摘要］目的：探讨贝那普利对2型糖尿病并发高血压患者内皮功能的血浆生物指标的影响。方法：32例2型糖尿病并高血压患者口服贝那普利片［(10～20)］mg/d 6个月，并以20例相匹配的健康者为对照。本组治疗前及治疗后6个月测定空腹血糖(FBG)、餐后2h血糖(2h_PBG)、血栓调节蛋白(Tm)、NO、vW因子水平及BP；采用高分辨率超声检测反应性充血和硝酸甘油介导的肱动脉舒张功能。结果：本组治疗后6个月与治疗前比，FBG、2h_PBG、含服硝酸甘油后右肱动脉内径的变化率均无统计学意义(P005)；血浆Tm和vW因子水平显著降低(P005)，血浆NO水平明显升高(P005)，反应性充血引起的右肱动脉内径的变化率明显升高(P005)。本组治疗后6个月收缩压和舒张压均较治疗前明显降低(P001)。结论：贝那普利治疗2型糖尿病并发高血压患者在降低BP的同时能有效地改善血管内皮依赖性舒张功能，且使血浆Tm和vW因子水平降低，NO水平升高。 　　［关键词］贝那普利；2型糖尿病；血栓调节蛋白；一氧化氮；vW因子　　［Abstract］Objective: To explore the effect of benazepril on plasma biomarkers of endothelial dysfunction in patients with type 2 diabetes mellitus complicated with hypertension. Methods: Thirty_two patients with type 2 diabetes mellitus complicated with hypertension were treated with benazepril［(10～20)mg/d］for 6 months. Twenty matched healthy people were taken as control. Before treatment and after 6 months of treatment, the fasting blood glucose(FBG), postprandial blood glucose(2h_PBG), thromodulin(Tm), von Willebrand factor and nitric oxide(NO)as well as systolic pressure(SBP)and diastolic pressure(DBP)were determined. The reactive congestion and nitroglycerin_induced dilation of the brachial artery were assayed with high_resolution ultrasound. Results: After 6 months of treatment in all patiens, FBG, 2h_PBG and diameter in brachial artery after summing glyceryltrinitrate showed no change markedly. The plasma levels of Tm, von Willebrand factor were reduced and NO was increased obviously than before treatment. The diameter in brachial artery in responding to reactive hyperaemia was improved greatly than before treatment. After 6 months of treatment, SBP and DBP were all cut down obviously than before treatment. Conclusion: Benazepril effectively reduces blood pressure,?improves endothelial_dependent vasodilatation concomitantly with a decrease in the plasma levels of Tm, von Willebrand factor and an increase in the plasma levels of NO