抗高血压药物对神经内分泌因子的干预作用

Effect of different antihypertensive drugs on the neuroendocrine in hypertensive patients

目的观察降压药物对高血压患者血中心钠素(ANP)、内源性类洋地黄物质(EDLS)、内皮素(ET)、一氧化氮(NO)等的干预作用,探讨神经内分泌因子与降压疗效的关系。方法将90例高血压病患者采用随机法分为三组,分别给予阿罗洛尔、咪唑普利及依那普利治疗6周,并检测治疗前后上述四种神经内分泌因子的血浓度。结果治疗后,三组诊室血压均明显下降(P<0.001),组间差异无显著性(P>0.05)。阿罗洛尔组治疗后ANP显著升高(P<0.001),ET、NO无变化(P>0.05);咪唑普利组与依那普利组ANP、ET降低,NO升高(P<0.05)。三组EDLS水平均降低(P<0.05)。结论三种药物均可有效降低血压,其疗效与上述神经内分泌因子的变化有关。

Objective： To observe the changes of endothelin （ET）, nictric oxide （NO）, atrial natriuretic pepfide （ANP） and endogenous digitalis-like substance （EDLS） atrial natriuretic peptide （ANP）, endogenous digitalis-like substance （EDLS） in plasma before and after treatmeat with arotinolol, imidapfil and enalapfil, to explore the effects of antihypertensive treatment on neuroendoerine factors in hypertensive patients. Methods： 90 patients with moderate essential hypertension were divided randomly into three groups and treated with arotinolol （20-30mg/d）, imidapril （5- 10mg/d） and enalapfil （5- 10rag/d） respectiveely. Plasma levels of ANP, EDLS, ET and NO were measured before and after treatment. Results： After six weeks therary, blood pressure decreased significantly in three group （P〈0. 01 ）, and there was no significant difference among three groups （P〉0. 05）. After treatment, the level of ANP in arotinolol group increased （P〈0. 001）, while that of ET and NO didn＇t change （P〉0. 05）; The plasma concentration of ET and ANP in imidapril and enalaprit groups decreased and that of NO increased significantly （P〈0. 05）. The level of EDLS decreased significantly in every group （P〈0.05）. Conclusions： All the three drugs can decrease blood pressure effectively. The efficacy of antihypertensive drugs has relation with the changes of neuendocrine substance above.