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目的:探讨卡托普利对高血压患者颈动脉粥样硬化(AS)的逆转作用。方法:将70例经彩色多普勒超声证实有颈AS的高血压患者随机均分为治疗组和对照组,治疗组35例在对照组常规治疗基础上服用卡托普利12．5 mg,tid,治疗6个月及12个月经彩色多普勒超声测定颈动脉内膜中膜厚度(IMT)、斑块病变类型、血管内径及血流参数,并与治疗前对比。结果:①2组患者血脂水平治疗前后无明显改变。②治疗组中Ⅰ型患者治疗后12个月从治疗前的57．14％减少到20％(P<0．05),而对照组无明显改变;治疗组患者治疗前后相比,或与同期对照组比较差异有统计学意义(P<0．05),2组Ⅱ-Ⅳ型患者治疗前后均无明显改变。③治疗组治疗后1MT 降低,血管内径增加;且随疗程延长,效果更明显,而对照组却无相应变化。④治疗组治疗后颈总动脉、颈内动脉的血管阻力指数均较治疗前明显降低,收缩期峰速度、舒张期末速度和血管搏动指数则较治疗前呈显著性增加, 且随疗程延长,有进一步降低或增加趋势,但对照组却无类似变化。结论:卡托普利可减轻血管IMT,改善血管的顺应性,降低血管阻力,改善颈动脉血流,随着治疗时间延长其效应更为显著。
Objective: To investigate the reversal effect of captopril on carotid atherosclerosis (AS) in hypertensive patients. Methods: Seventy patients with AS who had neck AS confirmed by color Doppler ultrasound were randomly divided into treatment group and control group. 35 patients in treatment group were given captopril 12.5 mg on the basis of conventional treatment, The carotid intima - media thickness (IMT), plaque lesions, blood vessel diameter and blood flow parameters were measured by color Doppler ultrasound after 6 months and 12 months of treatment. The results were compared with those before treatment. Results: ① There was no significant change in blood lipid level before and after treatment in the two groups. ② In the treatment group, the type I patients decreased from 57.14% before treatment to 20% (P <0.05) 12 months after treatment, while there was no significant change in the control group. The patients in the treatment group were significantly lower than those in the control group The difference between the two groups was statistically significant (P <0.05). No significant changes were found in the two groups of type Ⅱ-Ⅳ patients before and after treatment. ③ The treatment group after treatment 1MT decreased vascular diameter increased; and with prolonged course of treatment, the effect is more obvious, while the control group did not change accordingly. ④ After treatment, the vascular resistance index of common carotid artery and internal carotid artery in treatment group was significantly lower than that before treatment, and the peak systolic velocity, end diastolic velocity and vascular pulsatility index were significantly increased compared with before treatment, and with the prolongation of treatment, Further reduce or increase the trend, but there is no similar change in the control group. Conclusion: Captopril can reduce the vascular IMT, improve the vascular compliance, reduce vascular resistance, improve the carotid artery blood flow, with the treatment of time prolonging its effect is more significant.