氢氯噻嗪对高血压患者肾素-血管紧张素-醛固酮系统及生化指标的影响

Effects of Hydrochlorothiazide on Variety of Renin-angiotensin-aldosterone System and Biochemical Parameters in Hypertensive Patients

目的:观察不同剂量氢氯噻嗪(HCTZ)对原发性高血压患者肾素-血管紧张素-醛固酮系统(RAAS)活性及生化指标的影响。方法:选择2009年1月-2010年7月在我院治疗的120例轻、中度高血压患者,随机分为3组:对照组(A组)、HCTZ12.5mg组(B组)和HCTZ25.0mg组(C组)。A组:给予苯磺酸氨氯地平5mg,口服,qd;B组:在A组基础上加用HCTZ12.5mg,口服,qd;C组:在A组基础上加用HCTZ25.0mg,口服,qd。6周后比较各组患者血清RAAS活性和生化指标。结果:B组的血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD)浓度较A组高(P<0.05),血钾、血钠浓度下降不明显,血糖未见明显变化(P>0.05);C组血浆肾素(PRA)、AngⅡ和ALD较B组高(P<0.05),血钾、血钠浓度下降,血糖增高。结论:12.5mg的HCTZ即能激活RAAS活性,25.0mg的HCTZ对生化指标有较大影响。

OBJECTIVE：To observe the effects of different concentrations hydrochlorothiazide on variety of renin-angiotensin-aldosterone system and biochemical parameters in hypertensive patients.METHODS：120 cases with mild to moderate hypertension received medical treatment in our hospital during 2009.1-2010.7 They were randomly divided into 3 groups：control group（group A）,HCTZ 12.5 mg group（group B） and HCTZ 25.0 mg group（group C）.A group：40 patients received 5 mg amlodipine,oral once every day;group B：5 mg amlodipine＋12.5 mg HCTZ;group C：5 mg amlodipine ＋25.0 mg HCTZ.After 6 weeks,the RAAS activity and biochemical parameters of 3 groups were compared.RESULTS：The AngⅡ and ALD in serum of group B after treatment was higher than that of group A（P〈0.05）.Serum potassium,serum sodium and blood glucose did not change significantly.The AngⅡand ALD in serum of group C was higher than that of group B（P〈0.05）.Serum potassium and serum sodium was lower.Blood glucose was higher.CONCLUSION：12.5 mg HCTZ can activate the RAAS activity and 25.0 mg HCTZ has greater effect to biochemical parameters.