依那普利和非洛地平对原发性高血压患者TGF-β1、Bcl-2浓度的影响及临床意义的探讨

Clinical significance and altered TGF-β1,Bcl-2 concentration in hypertension patients after yenazepril and felodipine administration

目的研究原发性高血压(EH)患者血清中转化生长因子β1(TGF-β1)、B细胞淋巴瘤/白血病-2(Bcl-2)的浓度在依那普利和非洛地平治疗前后浓度的变化及临床意义。方法采用酶联免疫吸附法(ELISA)测定60例EH患者分别应用依那普利、非洛地平前后血清Bcl-2、TGF-β1浓度,并与30例健康人对照。结果与健康对照组相比,所有EH患者的TGF-β1、Bcl-2浓度均增高(P<0.01),应用降压药物依那普利及非洛地平治疗10d,两者降压作用相似,且均能使TGF-β1和Bcl-2浓度下降,但依那普利使这两种蛋白浓度改变更明显。结论Bcl-2、TGF-β1可能通过介导血管增生、重塑及部分通过凋亡参与原发性高血压发生、发展的病理过程,依那普利可能通过肾素-血管紧张素系统部分介导凋亡,减少TGF-β1、Bcl-2的合成。保持一定的细胞凋亡对维持血管正常结构和功能有重要意义。为进一步阐明高血压病发病机制及治疗提供理论论据。

Objective To observey the altered blood concentration of Bcl-2,TGF-β_1 and the clinical significance in patients with essential hypertension (EH) after yenazepril and felodipine administration. Methods Blood concentration of Bcl-2 and TGF-β_1 were measured in 60 patients with EH by ELISA before and after yenazepril and felodipine administration ,and were compared with 30 members of a healthy control group. Results Bcl-2 and TGF-β_1 concentration were higher in patients with hypertension than normotensive subject(P<0.01);Treatment of hypertensive patients with antihypertensive drugs caused a reduction in Bcl-2 and TGF-β_1 concentration ,which was more significant after administration of yenazepril than felodipine despite of the similar antihypertension effect.Conclusion Increased Bcl-2 and TGF-β_1 concentration in EH patients may contribute to the pathogesis of the disease through the vascular remodeling ,hypertrophy and partly apoptosis, yenazepril has greatly benefit in vascular architecture.