目的：探讨左旋氨氯地平与缬沙坦联合应用对血管内皮保护作用的影响。方法纳入共30只实验大鼠，分为五组；其中24只自发性高血压大鼠（SHR），随机分为左旋氨氯地平治疗组（A组），缬沙坦治疗组（B组），左旋氨氯地平+缬沙坦治疗组（C组）及空白对照组（D组），每组6只；6只魏-凯二氏大鼠（WKY）设为正常对照组（E组）。药物治疗及观察8周后测量无创血压及左室射血分数的变化。处死大鼠，分离心肌组织，计算全心重量/体重（HW/BW）、左室重量/体重（LVW/BW）；提取血浆，ELISA方法测定内皮型一氧化氮合酶（eNOS）、超氧化物歧化酶（SOD）、还原型烟酰胺腺嘌呤二核苷酸磷酸（NADPH）、白介素-6（IL-6)、肿瘤坏死因子-α（THF-α）。结果 A、B、C与D组相比，A、B、C三组大鼠血浆NADPH、IL-6、THF-α、HW/BW 、LVW/BW明显下降，SOD、eNOS明显升高，其中C组变化更为显著（177.3±3.8、5.1±0.8、47.9±3.1、83.9±3.9、127.0±9.7、5.2±0.4、3.3±0.2），提示两种药物联合具有交互作用；血压前后比较A、B、C三组均不同程度的下降，D组升高明显；左室射血分数差值水平的比较，A、B、C三组的变化无临床意义，D组下降明显。结论左旋氨氯地平、缬沙坦都具有良好的血管内皮保护作用；两者联合在血管内皮的保护上具有协同作用。
Objective To discuss the protective effect of levamlodipine combining valsartan on vascular endothelial function. Methods Test rats (n=24, with spontaneous hypertension) were divided into 5 groups:group A treated with levamlodipine, group B treated with valsartan, group C treated with levamlodipine combining valsartan, and group D (blank control group, each n=6), and other WKY rats (n=6) were chosen as group E (normal group). After treating and observing for 8 w, the changes of non-invasive blood pressure (NBP) and LVEF were observed. The ratio of heart weight to body weight (HW/BW), left ventricular weight to body weight (LVW/BW) were calculated after executed rats for separating myocardial tissue. The levels of endothelial nitric oxide synthase (eNOS), superoxide dismutase (SOD), reduced nicotinamide adenine dinucleotidephosphate (NADPH), interleukin-6 (L-6) and tumor necrosis factor-α (THF-α) were detected by using enzyme-linked immunosorbent assay (ELISA). Results The levels of NADPH, IL-6, THF-α, HW/BW and LVW/BW decreased significantly, and levels of SOD and eNOS increased significantly in group A, group B and group C compared with group D, and these changes were more significant in group C (177.3±3.8, 5.1±0.8, 47.9±3.1, 83.9±3.9, 127.0±9.7, 5.2±0.4, 3.3±0.2), which indicated that levamlodipine and valsartan had an interactive effect. NBP decreased in group A, group B and group C in varying degrees, and increased significantly in group D. LVEF had no significant changes in group A, group B and group C but decreased significantly in group D. Conclusion Levamlodipine and valsartan all have protective effects on vascular endothelial function, and they have an interactive effect when they are combined in clinical application.