卡维地洛对原发性高血压心肌组织特征及部分血管活性肽水平的改变

Changes of Cardiac Tissue Characteristics and Levels of Partial Plasma Vasoactive Peptides in Essential Hypertension After Carvedilol Administration

目的:应用超声声学密度技术探讨卡维地洛治疗原发性高血压患者左心室心肌组织密度的变化,分析治疗后部分血管活性肽心钠素、脑钠素、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)、胰岛素样生长因子-1(IGF-1)水平的改变及其与心肌组织密度变化的关系。方法:将入选对象101例分为无左心室肥厚组56例及伴左心室肥厚组45例,应用超声声学密度技术测量治疗前后左心室心肌不同切面的平均声学密度(AII％);测量治疗前后部分血管活性肽心钠素、脑钠素、ET-1、CGRP、IGF-1水平,分析治疗前后其变化规律及与心肌声学密度变化的关系。结果:卡维地洛治疗后原发性高血压左心室各室壁AII％之和(SUM)较治疗前有显著性下降(P<0．05)。心钠素、脑钠素、IGF-1在无左心室肥厚组有下降的趋势(P>0．05),ET-1有显著性下降(P<0．05)。在伴左心室肥厚组心钠素、ET-1、IGF-1有显著性下降(P<0．05),脑钠素有下降趋势(P>0．05)。CGRP水平治疗后无左心室肥厚组有升高趋势(P>0．05),伴左心室肥厚组有显著性升高(P<0．05)。伴左心室肥厚组心肌各切面室壁SUM在治疗前后的变化ΔSUM与ΔET-1、Δ心钠素、ΔIGF-1等各因子水平呈正相关,与ΔCGRP水平呈负相关。结论:卡维地洛能降低原发性高血压左心室心肌组织密度;能使原发性高血压左心室肥厚两组心钠素、ET-1、CGRP、IGF-1等部分血管活性肽向有利于维持正常血压水平的方向改变。

Objective： To investigate the changes of heart tissue characteristics before and after carvedilol administration in essential hypertension（ EH）, and to analyse how carvedilol affects the levels of partial plasma vasoactive peptides in EH patients. Methods： All the snbjects were divided into 2 groups. Group A included EH patients without left ventricular hypertrophy （ n = 56） and group B included EH patients with left ventricular hypertrophy （ n = 45 ）. Corrected acoustic densitometry （ AII% ） was examined by echocardiography and the levels of partial plasma vasoactive peptides were detected and analysed before and after carvedilol administration. Results ： After carvedilol administration there was a significant increased tendency of the AII% sum of the left ventricular wall in both groups（ P 〈 0. 05 ）. The decreased tendency of the plasma levels of ANP, BNP and IGF-1 was also found in group A（ P 〉 0. 05 ） , ET-1 （ P 〈 0. 05 ）. In group B （ P 〈 0. 05 ） ANP,ET-1 and IGF-1 were significantly decreased （ P 〈 0. 05 ）. After carvedilol treatment there was an increased tendency of plasma level of CGRP in group B （ P 〈 0. 05 ）. Conclusion： Carvedilol can alleviate AII% of left ventricular hypertrophy in EH patients. Carvedilol can reverse effectively the abnormal levels of partial plasma vasoactive peptides such as ANP, ET-1, CGRP and IGF-1 in EH patients.