拜心通对高血压左心室肥厚及肾素-血管紧张素-醛固酮系统的影响

Influence of Adalat GITS on renin angiotensin aldosterone system and mitigated hypertensive left ventricular hypertrophy

对比控释型钙拮抗剂（ＣａＡ）拜心通（ＡｄａｌａｔＧＩＴＳ）治疗前与治疗１２周及２４周，对高血压左心室肥厚（ＬＶＨ）患者的左心室质量指数（ＬＶＭＩ）、血浆肾素活性（ＰＲＡ）和血管紧张素Ⅱ（ＡＮＧⅡ）、醛固酮（ＡＬＤ）的血浆浓度的影响。结果：治疗１２周末时，ＬＶＭＩ由（１４０．６５±１４．６５）ｇ·ｍ－２降至（１１１．６２±１０．４９）ｇ·ｍ－２（Ｐ＜０．００１）。之后ＬＶＭＩ下降趋缓，２４周治疗结束时为（１０５．７９±１２．１３）ｇ·ｍ－２，较１２周末差异无显著性（Ｐ＞０．０５）；治疗１２周时ＰＲＡ和血浆ＡＮＧⅡ、ＡＬＤ浓度均有上升趋势，但均无显著性差异（Ｐ均＞０．０５），２４周末时，上述各指标变化不确定，亦无显著性差异（Ｐ均＞０．０５）。提示：控释型ＣａＡ对高血压合并ＬＶＨ者的交感神经系统无明显激活作用，且可显著减轻ＬＶＨ。

The comparison of the changes of left ventricular mass index(LVMI)and plasma renin activity (PRA) as well ws the plasma concentration of angiotensin Ⅱ (ANG Ⅱ) and aldosterone(ALD) among the hypertension patients with left ventricular hypertrophy (LVH) before and after 12 and 24 weeks treatment with Adalat GITS showed that LVMI dropped from (140.65±14.65) g·m -2 to (111.62± 10.49) g·m -2 (P< 0.001 ) after 12 weeks treatment.Then LVMI dropped slowly,and it was (105.79±12.13) g·m -2 after 24 weeks treatment.There was not significant difference between the date at the ends of 12 and 24 weeks(P>0.05).PRA and the plasma concentration of ANG Ⅱ and ALD had the tendency to rise but there was no significant difference at the end of the 12 weeks (P all>0.05).The changes of PRA and the plasma concentration of ANGⅡ and ALD were uncertain at the end of the 24 weeks and there was no significant difference too (P all>0.05).The study showed that the long term effect of the calciumion canal against drug doesnt stimulat the sympathetic nerve system but can drop LVH significantly.