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目的:观察以坎地沙坦为基础的降压治疗对原发性高血压患者颈动脉内中膜厚度、内中膜厚度/血管内径的影响,探讨坎地沙坦降血压以外的心血管保护作用。方法:63例1～2级原发性高血压患者,超声检测其颈动脉的内中膜厚度和内径,给予以坎地沙坦为基础的降压治疗,根据患者血压的反应加用小剂量的氢氯噻嗪,6个月后超声复查颈动脉情况。结果:63例原发性高血压患者,收缩压在治疗前为(155.08±7.926)mm Hg,治疗6个月后为(128.44±3.509)mm Hg;舒张压治疗前(96.06±4.586),治疗6个月后(81.24±4.257)mm Hg;心率治疗前为(77.21±7.565)次/min,治疗6个月后为(72.79±3.976)次/min,治疗前、后比较差异有统计学意义(P<0.05)。治疗6个月后,内中膜厚度较治疗前减少(0.088±0.046)mm,内径较治疗前增加(0.138±0.069)mm,内中膜厚度/血管内径较治疗前减少(0.032±0.020),差异均有统计学意义(P<0.01)。结论:以坎地沙坦为基础,加用小剂量利尿剂的降压方案具有良好的临床效果,具有确切的改善动脉粥样硬化作用。
OBJECTIVE: To observe the effect of candesartan-based antihypertensive therapy on carotid intima-media thickness, intima-media thickness / intravascular diameter in patients with essential hypertension and to investigate the cardiovascular protection beyond candesartan effect. Methods: Sixty-three patients with grade 1 or 2 essential hypertension were examined with ultrasound to evaluate the carotid intima-media thickness and inner diameter. Candesartan-based antihypertensive treatment was given. According to the patient’s blood pressure response, Of hydrochlorothiazide, 6 months after ultrasound review carotid artery. Results: In 63 patients with essential hypertension, systolic blood pressure was (155.08 ± 7.926) mm Hg before treatment and (128.44 ± 3.509) mm Hg after 6 months of treatment. Before diastolic blood pressure treatment (96.06 ± 4.586), treatment (81.24 ± 4.257) mm Hg after 6 months, (77.21 ± 7.565) / min before treatment and (72.79 ± 3.976) times / min after 6 months of treatment, with significant difference between before and after treatment (P <0.05). After 6 months treatment, the thickness of intima decreased (0.088 ± 0.046) mm, the diameter increased (0.138 ± 0.069) mm, the thickness of intima and the diameter of blood vessel decreased (0.032 ± 0.020) The differences were statistically significant (P <0.01). Conclusion: Candesartan-based antihypertensive regimen with low-dose diuretic has good clinical effect and definite effect of improving atherosclerosis.