伊贝沙坦对高血压患者醛固酮逃逸现象的影响

Effects of irbesartan on the aldosterone escape in essential hypertension

目的探讨伊贝沙坦对高血压患者使用血管紧张素抑制剂（ACEI）后并发醛固酮（Ald）逃逸现象的影响。方法166例高血压患者使用ACEI治疗3个月，放射免疫法测血浆醛固酮及血管紧张素Ⅱ浓度，根据醛固酮水平，判断有无并发醛固酮逃逸，对逃逸者加用伊贝沙坦治疗6个月，观察伊贝沙坦治疗后1、3、6个月对醛固酮逃逸现象的影响。结果使用伊贝沙坦治疗后1个月，血浆醛固酮及血管紧张素Ⅱ浓度明显下降（P〈0．01），3个月及6个月时回升，但仍然低于治疗前水平（P〈0．01）。至6个月时已经明显高于治疗后1、3个月水平（P〈0．01），但是3个月与1个月时相比并无明显差异（P〉0．05）。结论伊贝沙坦治疗后6个月内，可减少高血压患者并发醛固酮逃逸现象的发生；但6个月后可能再次出现醛固酮逃逸现象。

Objective To investigate the influence provided by irbesartan on aldosterone escape during angiotensin-eonverting enzyme inhibitor（ACEI） therapy in patients with essential hypertension （EH）. Methods 166 EH patients were treated with ACEL Plasma angiotensin Ⅱ（ Ang Ⅱ ） and aldosterone（Aid） concentrations were measured by radioimmunoassay following the therapy of 3 months treatment. Aldosteronc escape was estimated by the plasma Aid level after 3 months treatment. Patients with aldosterone escape were given irbesartan for 6 months. The aldosterone escape were observed following the therapy with irebesartan at 1,3,6 months. Results Following the treatment of irbesartan for 1 month,plasma Ang Ⅱ and Aid concentrations significantly decreased（ P 〈 0.01 ）. However, it began to increase after 3 and 6 months treatment, still lower than that of the therapy not given irbesartan（ P 〈 0.01 ）. The levels of plasma Ang Ⅱ and Aid were higher in 6 months than in 1,3 months （ P 〈 0.01 ）, but there are no differences between 1 and 3 months（P 〉 0.05）. Conclusion Irbesartan can reduce aldosterone escape during 6 months. But aldosterone escape may be occur again after 6 months treatment of irebesartan.