依那普利和尼群地平对高血压患者纤溶活性影响

Effects of enalapril and nitrendipine on the fibrinolytic activity in essential hypertension

目的探讨依那普利和尼群地平对高血压患者纤溶活性的影响。方法 37例,男性,原发性高血压(EH)患者随机分依那普利治疗组(n=18,5～10mg/d)和尼群地平治疗组(n=19,5～10mg/d)。检测治疗前和治疗后3月时血浆组织纤溶酶原激活剂(tPA)及其抑制物(PAI-1)活性。另设20例正常人做对照。结果治疗前两组tPA活性明显低于、PAI-1活性明显高于正常对照组。EH患者纤溶活性与高血压水平无显著相关性。治疗后两组血压显著下降并且程度相似。依那普利组tPA活性显著升高,PAI-1活性显著降低。尼群地平组tPA、PAI-1活性没有显著的变化。结论依那普利能提高EH患者纤溶活性,尼群地平无显著影响,对于有血栓形成高危的EH患者,选择能够提高纤溶活性的降压药物,对患者可能更为有利。

Objective To explore the effects of enalapril and nitrendipine on the fibrinolytic activity in essential hypertension. Methods Thirty - seven male patients with essential hypertension (EH) were randomized into enalapril group (n = 18, 5 ～ 10mg/d) and nitrendipine group (n= 19, 5～10mg/d) .Before and after drug administration, plasma activity of tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI - 1) were measured in all patients. Twenty normaltensive subjects as controls.Results Activity of tPA was significantly lower and PAI - 1 was significantly higher in the two hypertensive groups before treatment than in control group. Plasma activity of tPA and PAI - 1 didn' s correlate with blood pressure.In both hypertensive groups, blood pressure was significantly reduced to a similar level after drug treatment. In the enalapril group, tPA activity was significantly higher and PAI - 1 activity was significantly lower after drug treatment.In the nitrendipine group, there was no significant change in tPA and PAI - 1 activity after drug treatment. Conclusion Enalapril improved fibrinolysis but nitrendipine had no effects on fibrinolysis in EH.Considering the effects of antihypertensive drug on the fibrinolysis system, more beneficial treatment of hypertensive, especially at a high risk of therombus formation might be selected