培哚普利、非洛地平缓释片对老年原发性高血压患者血小板活化及纤溶活性的影响

The effect of perindopril and felodipine extended release tablets on platelet activation and fibrinolytic activity in elderly patients with essential hypertension

目的：探讨培哚普利及非洛地平缓释片对老年原发性高血压（ Ｅ Ｈ）患者血小板活化及纤溶活性的影响。方法：采用放射免疫法及发色底物法测定５５例老年Ⅰ、Ⅱ期 Ｅ Ｈ 患者分别应用培哚普利（Ⅰ组２８例）及非洛地平缓释片（Ⅱ组２７例）治疗前后活化血小板α颗粒膜蛋白（ Ｇ Ｍ Ｐ１４０）、组织型纤溶酶原激活剂（ｔ Ｐ Ａ）及其抑制物（ Ｐ Ａ Ｉ１）、血管紧张素Ⅱ（ ＡｎｇⅡ）及醛固酮（ Ａｌｄ）水平。结果：治疗后，两组患者 Ｇ Ｍ Ｐ１４０含量及 Ｐ Ａ Ｉ１活性均显著下降（ Ｐ 分别＜ ０．０１，０．０５），ｔ Ｐ Ａ 活性显著升高（ Ｐ ＜ ０．０５）；Ⅰ组患者 ＡｎｇⅡ及 Ａｌｄ 显著下降（ Ｐ ＜ ０．０１），Ⅱ组患者 ＡｎｇⅡ及 Ａｌｄ 未见明显变化（ Ｐ ＞ ０．０５）。治疗前，５５例 Ｅ Ｈ 患者 Ｇ Ｍ Ｐ１４０ 含量与 Ｐ Ａ Ｉ１水平呈显著正相关（ ｒ ＝０．４０７ ６， Ｐ ＜ ０．０１），二者与 ＡｎｇⅡ水平均呈显著正相关（ ｒ ＝ ０．４１６ ２，０．４２３７， Ｐ ＜ ０．０１）。结论：以上结果提示，培哚普利降低体内 ＡｎｇⅡ水平是其抑制老年 Ｅ Ｈ 患者血小板活化、改善纤溶活性的机制之一，而非洛地平缓释片抑制血小板活化、改善纤溶?

Objective:To evaluate the effect of perindopril and felodipine extended release tablets on platelet activation and fibrindytic activity in elderly hypertensives.Method:Radioimmunoassay and spectrophotometric assay were used to examine the levels of platelet alpha granule membrane protein (GMP 140), tissue type plasminogen activator (t PA) and its inhibitor (PAI 1), angiotensinⅡ(ANGⅡ) and aldosterone (Ald) after treatment with perindopril (group Ⅰ,n=28) and felodipine extended release tablets (group Ⅱ,n=27) in 55 elderly patients with essential hypertension (EH) of stage Ⅰ to Ⅱ. Result:After treatment, GMP 140 and PAI 1 activity significantly reduced (P< 0.01 , 0.05 respectively), but t PA activity significantly increased (P< 0.05 ) in both group. AngⅡ and Ald significantly reduced (P< 0.01 ) in group Ⅰ. No obvious changes of Ang Ⅱ and Ald were found in group Ⅱ. Before treatment, a positive correlation was noted between the levels of GMP 140 and PAI 1 (r= 0.407 6 ,P< 0.01 ),GMP 140 and AngⅡ(r= 0.416 2 ,P< 0.01 ),as well as PAI 1 and AngⅡ(r= 0.423 7 ,P< 0.01 ) in the 55 EH patients.Conclusion:These findings indicate that decreasing the levels of AngⅡ is one of the mechanism of perindopril to inhibit platelet activation and to improve fibrinolytic activity in elderly EH patients,but the effect of felodipine extended release tablets to inhibit platelet activation and to improve fibrinolytic activity has no relation to renin angiotensin system.