摘要
为转换酶抑制剂（ＡＣＥＩ）治疗高血压提供理论依据。方法２５例高血压患者按内生肌酐清除率分为肾功能正常１０例，代偿８例和氮质血症７例３组。观察ＡＣＥＩｅｎａｌａｐｒｉｌ（１０～３０ｍｇ／ｄ）４周对血管活性物质，包括血浆肾素活性（ＰＲＡ），血管紧张素Ⅱ（ＡＴⅡ），转换酶（ＡＣＥ），心钠素（ＡＮＦ），尿醛固酮（Ａｌｄｏ），缓激肽（ＢＫ）和前列腺素Ｅ２（ＰＧＥ２）的作用。结果１．服药前３组患者与正常人比，ＡＴⅡ升高，ＰＲＡ，Ａｌｄｏ无差异；氮质血症组患者ＢＫ降低，ＡＮＦ增高；２．服药后３组患者ＡＴⅡ，Ａｌｄｏ和ＡＮＦ下降，ＢＫ（除氮质血症组），ＰＧＥ２和ＰＲＡ升高；３．治疗后ＡＴⅡ与Ａｌｄｏ、ＡＴⅡ与ＡＮＦ以及ＢＫ与ＰＧＥ２分别呈正相关。结论１．肾素－血管紧张素系统（ＲＡＳ）与ＢＫ－ＰＧＳ两系统相互调节在不同肾功能高血压患者的发病中起着作用，并有着治疗意义；２．
bjectiveTogainaproofofangiotensinconvertingenzymeinhibitor(ACEI)intreatinghypertensioninthe┐ory.MethodsAccordingtocreatinineclearancelevels,twenty-fivehypertensivepatientsweredividedinto3groups:1.withnormalrenalfunction(10patients);2.compensatedstageofrenalinsuficiency(8patients);and3.azotemiastage(7patients).Theshort-term(4weeks)efectofenalaprilmonotherapy(10～30mg/d)onva-soactivesubstancesincludingplasmareninactivity(PRA),angiotensinⅡ(ATⅡ),angiotensinconvertingemzyme(ACE),atrialnatriureticfactor(ANF),urinaryaldosterone(Aldo),bradykinin(BK),andprostaglandinE2(PGE2)wereassessed.Results1.Comparedwithnormalsubjects,ATⅡwasincreasedin3groupsbeforeenalapriladministrationbutnosignificantdiferencewasrecordedinthe3groupsforPRAandAldo,whileBKwasdecreasedandANFwaselevatedinazotemiastagegroup,2.AfterenalaprilmonotherapyATⅡ,Aldo,andANFdecreasedinthe3group,whileBK(exceptazotemiagroup),PGE2,andPRAincreased,3.ApositivecorrelationwasobservedbetweenATⅡandAldo,ATⅡandANFaswelasbetweenBKandPGE2afterenalapriladmini┐trarion.Conclusion1.Theregulativerelationshipbetweenrenin-angiotensinsystem(RAS)andbradykinin-prostaglandinsystem(BK-PGS)mayplayaroleinthepathogenesisofrenalfunctionimpairmentinpatientswithhypertension,thismayalsohavetherapeuticimplications;2.TheantihypertensiveandrenalprotectiveefectsofenalaprilmaybemediatedbydepressingtheRASandactivatingtheBK-PGS.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
1996年第4期210-213,共4页
Chinese Journal of Nephrology
基金
国家自然科学基金
