【作者】 周宇；

【导师】 杨侃； 李静乐；

【作者基本信息】 中南大学 ， 临床医学， 2013， 硕士

【摘要】 目的：探讨吸烟对氨氯地平的降压疗效、相关炎性因子MCP-1、 Hs-CRP、ADP及BaPWV和ABI的影响。方法：选取120例轻中度男性高血压患者,分为吸烟组和不吸烟组,每组各60例,观察两组患者服用氨氯地平12周(5mg, Qd)后的降压疗效以及治疗前后MCP-1、Hs-CRP、ADP、BaPWV和ABI的变化。并选择60名体检正常的男性不吸烟者作为对照组。采用ELISA法测定MCP-1、Hs-CRP、ADP的含量,动脉硬化检测仪测定研究者双侧BaPWV及ABI。结果：1.与对照组相比,高血压不吸烟组MCP-1、ADP、Hs-CRP、 BaPWV均有显著升高,但ABI尚未达到统计学差异,而吸烟组上述各指标均达到统计学差异(P<0.01)。高血压吸烟组MCP-1、BaPWV均高于不吸烟组,ADP、ABI均低于不吸烟组,上述指标均具有统计学差异(P<0.01),但两组之间Hs-CRP比较无统计学差异(P>0.05)。2.经氨氯地平治疗后吸烟组与不吸烟组降压总有效率分别为53.3%、60%,组间比较无统计学差异(P>0.05)。3.与治疗前比较,经氨氯地平治疗后吸烟组只有Hs-CRP达到了统计学差异,而不吸烟组MCP-1、Hs-CRP、ADP的改变均有统计学差异。4.经氨氯地平治疗后不吸烟组BaPWV、ABI较治疗前均有统计学意义,而吸烟组无明显改变。结论：1.男性高血压病患者的炎症因子水平和动脉硬化程度明显升高,吸烟可进一步加重这种改变；2.吸烟对服用氨氯地平的轻中度男性高血压患者的降压疗效无明显影响；3.氨氯地平在降压的同时,还对男性高血压患者的炎症状态及动脉硬度有改善作用,但吸烟可降低这种效应。更多还原

【Abstract】 Objective:To evaluate the effects of smoking on the antihypertensive efficacy and MCP-1,Hs-CRP,ADP and BaPWV,ABI of amlodipine.Methods:We selected120cases of mild to moderate male hypertensive patients,and they were divideded into smoking group (60cases) and non-smoking group (60cases). And all patients took amlodipine (5mg, Qd) for12weeks. Antihypertensive effect and the level of MCP-1,Hs-CRP,ADP,BaPWV,ABI were observed before and after treatment. And we selected60male who were non-smokers and whose physical examination were normal at the same time as a control group. MCP-1, Hs-CRP, ADP level were detected by ELISA,BaPWV and ABI were measured by arteriosclerosis detector.Results:1. Compared with the control group, the level of MCP-1, ADP, Hs-CRP and BaPWV in the non-smoking group were markedly different, but the level of ABI had no significant difference between the two groups,and all indicators in the Hypertension-smoking group had reached a significant difference(P<0.01).The level of MCP-1,BaPWV in the Hypertension-smoking group were higher than the non-smoking group, the level of ADP,ABI were lower,and the above indicators had a statistically significant difference (P<0.01), but the level of Hs-CRP had no significant difference between the two groups(P>0.05).2. After the treatment of amlodipine, the total effective rate of smoking group and non-smoking was53.3%,60%respectively,and there was no significant difference between the two groups.3.Compared with pre-treatment,there was only Hs-CRP reached statistical difference in smoking group, rather than the MCP-1, Hs-CRP, ADP level were all statistically significant in non-smoking group.4.Aafter the treament of amlodipine, the level of BaPWV and ABI in the non-smoking group were statistically significant,but the smoking group was no statistically significant.Conclusion:1.The level of inflammatory and arteriosclerosis factors in men with essential hypertension was significantly higher,and smoking can further aggravate the change.2. Smoking had no significant effect on antihypertensive efficacy of those mild to moderate male hypertensive patients who take amlodine.3.Amlodipine not only had an effect on antihypertensive,it is also in favour of reducing the level of inflammation status and atherosclerosis of those mild to moderate male hypertensive patients,but smoking can affect the role at the same time.更多还原