中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
25期
3-6
,共4页
李国栋%陈凯明%祝黎东%胡健
李國棟%陳凱明%祝黎東%鬍健
리국동%진개명%축려동%호건
高血压%一氧化氮%缓激肽%阿利吉仑
高血壓%一氧化氮%緩激肽%阿利吉崙
고혈압%일양화담%완격태%아리길륜
Hypertension%Nitric oxide%Bradykinin%Aliskiren
目的 分析血一氧化氮(NO)、缓激肽(BK)及非优势臂坐位血压等指标在应用阿利吉仑及雷米普利前后的变化特点,探讨阿利吉仑对原发性高血压患者血NO、BK的影响及其临床意义.方法 选取轻、中度原发性高血压患者67例,经过2周的单盲安慰剂导入后,根据随机表上获得的随机号被分配到不同组别,各组均连续用药8周.试验揭盲显示:试验组50例(阿利吉仑组),给予阿利吉仑治疗,又分为三个亚组,300mg组(16例)、150mg组(17例)、75mg组(17例);对照组17例(雷米普利组),给予雷米普利5 mg治疗.采用双抗体夹心酶联免疫吸附试验测定血NO及放射免疫分析测定血BK用药前后浓度,测量患者用药前后非优势臂坐位血压.结果 阿利吉仑组用药后,NO浓度升高[300mg组、150mg组、75mg组用药前分别为(44.414±5.841)、(43.496±5.576)、(41.037±5.312)μmol/L,用药后分别为(60.381±6.756)、(56.480±6.959)、(53.766±7.276)μmol/L],非优势臂坐位血压降低,差异均有统计学意义(P<0.05),但阿利吉仑组用药前后血BK浓度比较差异无统计学意义(P>0.05).雷米普利组用药后,血NO、BK浓度较用药前均显著增加[(57.286±6.431)μmol/L比(39.935±6.388)μmol/L,(7.120±1.015)μg/L比(5.232±1.288)μg/L],非优势臂坐位血压降低,差异均有统计学意义(P<0.05).结论 阿利吉仑与雷米普利均显著增加血NO水平.雷米普利显著增加血BK水平,但阿利吉仑不影响.
目的 分析血一氧化氮(NO)、緩激肽(BK)及非優勢臂坐位血壓等指標在應用阿利吉崙及雷米普利前後的變化特點,探討阿利吉崙對原髮性高血壓患者血NO、BK的影響及其臨床意義.方法 選取輕、中度原髮性高血壓患者67例,經過2週的單盲安慰劑導入後,根據隨機錶上穫得的隨機號被分配到不同組彆,各組均連續用藥8週.試驗揭盲顯示:試驗組50例(阿利吉崙組),給予阿利吉崙治療,又分為三箇亞組,300mg組(16例)、150mg組(17例)、75mg組(17例);對照組17例(雷米普利組),給予雷米普利5 mg治療.採用雙抗體夾心酶聯免疫吸附試驗測定血NO及放射免疫分析測定血BK用藥前後濃度,測量患者用藥前後非優勢臂坐位血壓.結果 阿利吉崙組用藥後,NO濃度升高[300mg組、150mg組、75mg組用藥前分彆為(44.414±5.841)、(43.496±5.576)、(41.037±5.312)μmol/L,用藥後分彆為(60.381±6.756)、(56.480±6.959)、(53.766±7.276)μmol/L],非優勢臂坐位血壓降低,差異均有統計學意義(P<0.05),但阿利吉崙組用藥前後血BK濃度比較差異無統計學意義(P>0.05).雷米普利組用藥後,血NO、BK濃度較用藥前均顯著增加[(57.286±6.431)μmol/L比(39.935±6.388)μmol/L,(7.120±1.015)μg/L比(5.232±1.288)μg/L],非優勢臂坐位血壓降低,差異均有統計學意義(P<0.05).結論 阿利吉崙與雷米普利均顯著增加血NO水平.雷米普利顯著增加血BK水平,但阿利吉崙不影響.
목적 분석혈일양화담(NO)、완격태(BK)급비우세비좌위혈압등지표재응용아리길륜급뢰미보리전후적변화특점,탐토아리길륜대원발성고혈압환자혈NO、BK적영향급기림상의의.방법 선취경、중도원발성고혈압환자67례,경과2주적단맹안위제도입후,근거수궤표상획득적수궤호피분배도불동조별,각조균련속용약8주.시험게맹현시:시험조50례(아리길륜조),급여아리길륜치료,우분위삼개아조,300mg조(16례)、150mg조(17례)、75mg조(17례);대조조17례(뢰미보리조),급여뢰미보리5 mg치료.채용쌍항체협심매련면역흡부시험측정혈NO급방사면역분석측정혈BK용약전후농도,측량환자용약전후비우세비좌위혈압.결과 아리길륜조용약후,NO농도승고[300mg조、150mg조、75mg조용약전분별위(44.414±5.841)、(43.496±5.576)、(41.037±5.312)μmol/L,용약후분별위(60.381±6.756)、(56.480±6.959)、(53.766±7.276)μmol/L],비우세비좌위혈압강저,차이균유통계학의의(P<0.05),단아리길륜조용약전후혈BK농도비교차이무통계학의의(P>0.05).뢰미보리조용약후,혈NO、BK농도교용약전균현저증가[(57.286±6.431)μmol/L비(39.935±6.388)μmol/L,(7.120±1.015)μg/L비(5.232±1.288)μg/L],비우세비좌위혈압강저,차이균유통계학의의(P<0.05).결론 아리길륜여뢰미보리균현저증가혈NO수평.뢰미보리현저증가혈BK수평,단아리길륜불영향.
Objective To investigate the effects of aliskiren on blood nitric oxide (NO) and bradykinin (BK) through analyzing the changes of NO, BK and non-dominant arm blood pressure before and after treatment of aliskiren and ramipril. Methods The chnical trial was conducted in 67 patients with essential hypertension. After a single-blind period of taking placebo orally once a day for 2 weeks, the patients were divided into different group in accordance with random table, and all patients were consecutively treated with drugs for 8 weeks. The trial uncovered showed that 17 patients were treated with ramipril (5 mg) in control group. Patients in trial group were given aliskiren and were assigned to three subgroups, 300 mg group (300 mg aliskiren, 16 cases), 150 mg group (150 mg aliskiren, 17 cases) and 75 mg group (75 mg aliskiren, 17 cases). The blood NO and BK before and after treatment in two groups were measured by enzyme linked immunosorbent assay and radioimmunoassay method. Non-dominant arm blood pressure was measured by calibration qualified mercury blood pressure instrument before and after treatment. Results The blood NO after treatment of aliskiren 8 weeks in trial group increased significantly than those before treatment [before treatment, the blood NO in 300 mg group, 150 mg group,75 mg group were (44.414 ±5.841 ), (43.496 ± 5.576), (41.037 ± 5.312) μ mol/L, after treatment they were(60.381 ± 6.756), (56.480 ±6.959), (53.766 ±7.276) μmol/L] (P <0.05). After treatment, non-dominant arm blood pressure decreased significantly in trial group (P < 0.05 ), but the blood BK had no significant defference before and after treatment (P >0.05). The blood NO and BK after treatment of ramipril 8 weeks in control group increased significantly than those before treatment [(57.286 ±6.431) μmol/L vs. (39.935 ±6.388)μ mol/L, (7.120 ± 1.015) μg/L vs. (5.232 ± 1.288) μg/L], and meanwhile non-dominant arm blood pressure decreased significantly (P <0.05). Conclusions Aliskiren and ramipril could increase the concentration of NO remarkably. Ramipril has strong effect in increasing the concentration of BK, but aliskiren hasn't effect on BK.
