不同类型降压药物对肾内血流动力学长期影响的研究

Long-term Effect of Different Antihypertensive Agents on Renal Hemodynamics

目的明确不同降压药物对肾内血流动力学的长期影响。方法回顾性分析了接受不同降压药物治疗的高血压病患者52例。根据服用药物的种类分为3组血管紧张素转换酶抑制剂(ACEI)组、钙拮抗剂(CCB)组和β受体阻滞剂(βB)组。采用标准汞柱式血压计以Korotkoff法测量右上臂血压;采用超声多普勒肾血流测定患者服药前后肾内血流的变化。结果ACEI组和CCB组段动脉各项血流参数的改变与血压降低的程度相关;叶间动脉多数指标的变化与血压降低程度之间也相关。但βB组血压降低的程度与多数血流参数的变化无相关性。结论肾内血流动力学的改善与系统血压降低有一定的相关性;同时又与药物自身的作用机制密切相关。

Objective To investigate the long term effect of different antihypertensive agents on renal hemodynamics with ultrasound Doppler. Methods 52 essential hypertensive patients were divided into three groups according to the antihypertensive agent they took： angiotensin-converting-enzyme inhibitor （ACEI）, calcium channel blocker （CCB） and β-adrenoceptor blocker （βB）. The blood pressures of right upper arms were measured with mercury column blood pressure gauge using Korotkoff method. Renal hemodynamics were examined with ultrasound Doppler before and after treatment with agents. Results Systolic blood pressure （SBP） and diastolic blood pressure （DBP） of all patients were decreased significantly. An significant correlation was found between the deceases of blood pressure and the betterment of renal homodynamic parameters in ACEI and CCB groups, but not in βB group. Conclusion To a degree, the betterment of renal hemodynamics is correlation with the reduction of systemic blood pressure and mechanism of action of antihypertensive agents.