降压达标高血压病患者胰岛素样生长因子-1与踝-臂脉搏波传导速度的变化

目的探讨高血压病患者给予苯磺酸氨氯地平片及替米沙坦片联合降压治疗前后血清胰岛素样生长因子-1（IGF-1），踝一臂脉搏波传导速度（baPWV）变化及血压达标对后两者的影响。方法68例高血压痛患者苯磺酸氨氯地平片及替米沙坦片联合降压治疗24周前后，测定血压、空腹血糖（FBS）、血清总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）、血肌酐（cr）、血尿素氮（BUN）、肝功能、血清IGF-1（酶联免疫吸附法）及baPWV。结果①高血压3级患者的IGF-1水平与baPWV较高血压1级明显增高（P＜O．05）；②高血压病患者治疗前后血清IGF-1水平与baPWV呈正相关（治疗前r^5=0．506，治疗后r^5=0．492，均P＜0．05）；③联合降压治疗24周后血清IGF-1及baPWV水平较治疗前均显著降低（均P＜0．05），且血压控制达标患者的IGF-1与baPWV的水平较未达标者降低更明显（P＜0．05）。结论苯磺酸氨氯地平与替米沙坦联合降压治疗能显著下调高血压病患者的IGF-1水平并降低baPWV，且降压治疗达标者的IGF-1及baPW-V降低更显著。

Change of Insulin-Like Growth Factor-1 and Brachial-Anlde Pulse Wave Velocity in Essential Hypertensive Patients with Blood Pressure Control

Objective To study the change of serum insulin-like growth factor-1 （IGF-1） and brachial-ankle pulse wave velocity （baPWV） in patients with essential hypertension （EH） after treated with combined amlodipine and telmisartan therapy for 24 weeks. Methods Sixty-eight patients with EH were treated with combined amlodipine and telmisartan therapy. Serum IGF-1 was examined by enzyme-linked immunosorbent assay, brachial-ankle pulse wave velocity was measured by automatic arteriosclerosis detector （Omron, VP-1000）. The levels of blood-lipoids, blood-fasting sugar, Cr and BUN were detected before combined antihypertensive therapy. All subject needed to undertake again after combined amlodipine and telmisartan therapy for 24 weeks, the results were taken to compare with that of pre-therapy. Results ①Serum IGF-1 level in patients with three grade of EH was significantly higher than that in patients with one grade EH （P 〈0.05）.②Whether before or after antihypertensive therapy, serum IGF-1 correlated positively with baPWV （before antihypertensive therapy： r^5= 0.506,P 〈0.05; after antihypertensive therapy： r^5= 0.492, P 〈0.05）. ③After 12 weeks＇ treatment, compared with abnormal blood pressure group, the patients in successful blood pressure control group had lower serum levels of IGF-1 （P〈0.05） and smaller values of baPWV （P〈0.05）. Conclusions Combined amlodipine and telmisartan therapy after 24 weeks down regulates the serum level of IGF-1 and baPWV in patients with essential hypertension. The level of IGF-1 and baPWV with control to normal blood pressure is lower than that with abnormal blood pressure.