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（ＡｄａｌａｔＧＩＴＳ）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（ＡｎｇⅡ）和醛固酮水平的变化，并对ＳＰ水平与ＬＶＭⅠ和ＡｎｇⅡ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，ＡｎｇⅡ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?
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 SP went up and those of AngⅡ and Ald reduced ( P <0.001). In groupⅡ, no obvious changes in the parameters were found ( P >0.05). Before treatment, a negative correlation was noted between the levels of SP and LVMIs ( r =-0.4115, P <0.0025). After treatment, the negative correlation in the group Ⅰ was strengthened ( r =-0.5579, P <0.0005), while, in group Ⅱ, no linear correlation was found ( r =-0.029, P >0.25). Before treatment, in the 53 patients showed no linear correlation between the levsls of SP and AngⅡ ( r =-0.1403, P >0.10). Conclusion SP and AngⅡ are a pair of antagonist substances of vessel activity, which antagonize with each other in EH patients, and angiotensin converting enzyme (ACE) is a regulating pivot of the pair of antagonists. ACE is one of the key substances keeping the balance between promoting and inhibiting factors affecting LVH. In addition, Adalat GITS does not activate the RAS and the sympathetic nervous system in EH patients accompanied with LVH.
出处
《中华心血管病杂志》
CSCD
北大核心
1998年第3期212-214,共3页
Chinese Journal of Cardiology
关键词
高血压
左心室肥厚
药物疗法
依那普利
硝苯啶
enalapril
Adalat GITS
hypertension
substance P
renin angiotensin system
