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依那普利 硝苯啶控释片对高血压左心室肥厚者P物质和肾素 |
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赵友民 黄振文 李莉 郭文涛 崔天祥
朱海玲 吕聪敏 崔豫 孙铭毅 胡亚兰
【摘要】 目的 为研究P物质(SP)与左心室肥厚(LVH)和肾素-血管紧张素系统(RAS)的关系及明确血管紧张素转换酶抑制剂(ACEI)逆转LVH的机制。方法 53例合并LVH的高血压病患者随机分为依那普利(enalapril)组(Ⅰ组，27例)和硝苯啶控释片(Adalat GITS)组(Ⅱ组，26例)。观察治疗前与治疗12周后左室质量指数(LVMI)，血浆SP、血管紧张素Ⅱ(Ang Ⅱ)和醛固酮水平的变化，并对SP水平与LVM Ⅰ和Ang Ⅱ水平分别进行相关分析。结果 治疗后两组LVMI均显著下降(P均<0.001)，Ⅰ组SP升高，Ang Ⅱ和Ald降低，差异有显著性(P均<0.001)，Ⅱ组上述参数未见明显变化(P均>0.05)。治疗前53例患者血浆SP水平与LVMI存在负相关关系(r=-0.4115)，治疗后Ⅰ组负相关关系强化(r=-0.5579)，Ⅱ组治疗后未呈直线相关关系(r=0.029)；治疗前53例患者血浆SP与AngⅡ水平间无相关关系(r=0.1403)，治疗后Ⅰ组呈弱负相关关系(r=-0.3586,0.025<P<0.05)，Ⅱ组未显示直线相关关系(r=-0.1967,P>0.10)。结论 ACEI减轻LVH的机制部分源于其升高血浆SP水平；SP与AngⅡ是一对互相拮抗的血管活性物质，是LVH的促进和抑制因素中起关键作用的物质之一；硝苯啶控释片对合并LVH的高血压病患者的RAS和交感神经系统无明显激活作用。
【关键词】 依那普利 硝苯啶控释片 高血压 P物质 肾素-血管紧张素系统
The effect of enalapril and Adalat GITS on substance P and renin-angiotensin system in patients with hypertension accompanied with left ventricular hypertrophy Zhao Youmin, Huang Zhenwen, Li Li, et al. Cardiovescular Department, Henan Provincial Chest Hospital, etc., Zhengzhou 450003
【Abstract】 Objective To study the relations between substance P and left ventricular hypertrophy (LVH), as well as the renin-angiotensin system (RAS) and to define the mechanism of angiotensin-converting enzyme inhibitor (ACEI) for the mitigation of LVH. Methods 53 patients with essential hypertension (EH) accompanied with LVH were divided randomly into two groups: group Ⅰ treated with enalapril (n=27) and group Ⅱ treated with Adalat GITS (n=26). The changes of the left ventricular mass index (LVMI), the levels of substance P (SP) and angiotensin Ⅱ (AngⅡ), and aldosterone (Ald) in plasma were observed before and after 12-week treatment. Linear correlation analysis was made between the levels of SP and LVMI as well as the levels of AngⅡ in the two groups. Results The LVMIs in the two groups were significantly lower than those before treatment (P<0.001, respectively). In group Ⅰ, the levels of S[1] [2] [3] 下一页
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