阿利吉仑对原发性高血压患者血清高敏C反应蛋白的影响与机制探讨

Effects of Aliskiren on Serum High-sensitivity C-reactive Protein in Essential Hypertension Patients

目的分析血管紧张素Ⅱ(AngⅡ)、高敏C反应蛋白(hs-CRP)、白细胞计数及非优势臂血压等指标在应用阿利吉仑及雷米普利前后的水平变化,探讨阿利吉仑对原发性高血压患者血清hs-CRP的影响。方法选取原发性高血压患者67例。其中,对照组(n=17),给予雷米普利5mg治疗;实验组(n=50),给予阿利吉仑治疗,分为3个亚组,300mg组(n=16)、150mg组(n=17)、75mg组(n=17)。采用双抗体夹心ELISA法测定血清AngⅡ及hs-CRP用药前后浓度,应用流式细胞计数法检测患者用药前后血白细胞计数水平变化,应用校准合格的水银血压仪测量患者用药前后非优势臂坐位血压。结果应用阿利吉仑8周后AngⅡ及hs-CRP的浓度、白细胞计数及非优势臂坐位血压较用药前均有显著性差异(P<0.05);应用雷米普利8周后AngⅡ、hs-CRP浓度较用药前未见显著性降低(P>0.05),白细胞计数及非优势臂血压较用药前有显著性差异(P<0.05)。结论与雷米普利相比,阿利吉仑不仅显著的降低了血清AngⅡ水平且具有更强的降低hs-CRP的作用。

Objective To investigate the effects and mechanisms of Aliskiren on serum high-sensitivity C-reactive protein through analyzing the changes of angiotensin Ⅱ（AngⅡ）,high-sensitivity C-reactive protein（hs-CRP）,white blood cell count and undominant arm blood pressure before and after treatment of Aliskiren and Ramipril. Methods The clinical trial was conducted in 67 essential hypertension patients. 17 of the patients were treated with Ramipril（5 mg）as the control group. The trial group was given Aliskiren and was assigned into 3 subgroups,which were treated with 300 mg（n =16）,150 mg（n =17）and 75 mg（n =17）Aliskiren. Before and after treatment of Ramipril and a Aliskiren,the serum concentrations of AngⅡ and hs-CRP were measured by ELISA method,white blood cell count was measured by flow cytometry and the undominant arm blood pressure was measured by calibration qualified mercury blood pressure instrumentl. Results After 8 weeks of Aliskiren treatment,the serum concentrations of Ang Ⅱand hs-CRP,white blood cell count and undominant arm blood pressure of the trial group were significantly different with those before Aliskiren treatment （P 0.05）. The serum concentrations of Ang Ⅱand hs-CRP after 8 weeks of Ramipril treatment had no significant difference compared with those before Ramipril treatment （P 0.05）. White blood cell count and undominant arm blood pressure after 8 weeks ramipril treatment had significant difference compared with those before ramipril treatment （P 0.05）. Conclusion In the treatment of essential hypertension patients,Aliskiren has stronger effect on decreasing the serum concentrations of Ang Ⅱand hs-CRP than Ramipril.