高血压病患者血浆内皮素变化与硝苯地平缓释剂对其影响

Plasma endothelin in hypertensives and its change after nifedipine treatment

目的了解高血压病患者血浆内皮素变化以及硝苯地平缓释剂对其影响。方法以放射免疫法测定９９例高血压病患者和１７例健康体检者血浆内皮素浓度，并给２５例Ⅱ、Ⅲ期高血压病患者以硝苯地平缓释剂治疗２周后复测内皮素。结果Ⅰ、Ⅱ、Ⅲ期高血压病患者和健康者的血浆内皮素浓度分别为４１５±１７８、９６０±４８３、１３７０±４００、４５５±２２８ｎｇ／Ｌ，Ⅱ、Ⅲ期高血压组内皮素明显高于健康对照组，其浓度与收缩压、舒张压均呈显著正相关。按舒张压分级，血压升高程度越重，内皮素浓度越高；而合并或不合并左室肥厚组的内皮素浓度差异无显著性。硝苯地平缓释剂治疗２周后，随血压的下降，内皮素浓度亦明显降低，但仍高于健康对照组。结论内皮素与血压升高有着密切联系，可能参与高血压病的发生与发展，钙离子拮抗剂硝苯地平缓释剂能在有效地控制血压的同时明显降低血浆内皮素浓度。

Objective To explore the role of plasma endothelin (ET) in hypertensives and its change after nifidipine treatment. Methods Plasma ET was measured by radiommunoassay in 99 patients with essential hypertension (EH) and 17 healthy individuals as control. 25 EH patients in stage Ⅱ and Ⅲ were treated with nifidipine SR (sudtained release) for two weeks. Results Plasma ET in EH stage Ⅰ,Ⅱ,Ⅲ and healthy individuals were 41.5±17.8, 96.0±48.3, 137.0±40.0 and 45.5±22.8 ng/L respectively. Plasma ET in EH stage Ⅱ and Ⅲ was significantly higher than that in normal individuals. Positive correlation existed between ET and the levels of systolic and diasolic pressure, especially the diastolic pressure. No correlation was found between ET and the presense or absence of left ventricular hypertrophy. After 2 weeks of nifidipine SR treatment, ET level in EH decreased evidently with the reduction of blood pressure but was still higher than that in healthy individuals. Conclusion It is suggested that ET is closely related with the rise of blood pressure and may play a role in the development and progression of EH. Nifidipine reduces the plasma ET when the blood pressure is effectively controlled.