缓释维拉帕米对高血压患者交感活性的影响

The Effects of Sympathetic Nervous System Activity after SR Verapamil \;Treatment in Essential Hypertension

通过握力试验激发高血压患者的交感活性。分析交感活性与血压、心率及循环中内分泌激素的变化关系，及缓释异搏定对交感活性的影响。 方法：对４６ 例高血压患者选用握力试验方法，测量握前握中握后的血压、心率，并测定血浆中儿茶酚胺（ Ｃ Ａ）及肾素－ 血管紧张素－ 醛固酮（ Ｒ Ａ Ｓ）的浓度，经６ 周缓释异搏定２４０ ｍ ｇ／ｄ 的治疗，重复测定上述指标， Ｃ Ａ采用高压液相色谱方法， Ｒ Ａ Ｓ采用放免方法操作完成。 结果：（１）治疗前最大握力试验时血压上升百分比 Ｓ Ｂ Ｐ／ Ｄ Ｂ Ｐ２０．３／２０．４％ ，心率则增快１４．５％ ，治疗６ 周后，最大握力时血压仅上升７．８％ ／７．３％ ， Ｐ＜ ０．０５。心率增快为５．３％ ， Ｐ＜ ０．０５；（２）缓释异搏定治疗后去甲肾上腺素（ Ｎ Ｅ）、血管紧张素（ Ａ）、醛固酮（ Ａｌｄ）浓度明显下降，与治疗前比 Ｐ＜ ０．０１，血压明显下降 Ｐ＜ ０．０１。 结论：通过握力试验方法可以判断高血压患者的交感活性，钙拮抗剂缓释异搏定能明显降低血浆中 Ｎ Ｅ、 Ａ、 Ａｌｄ 水平及交感神经活性，使血压平稳下降。

Aims:To determine the sympathetic activity in essential hypertension after the treatment of verapamil SR.\ Methods:Handgrip test was assumed to induce sympathetic activity.The response of BP,HR,plasma catecholamine(CA),angiotensin Ⅱ(AⅡ),aldosterone(ALD) to handgrip test before and after 6 weeks verapamil SR treatment were determined. Plasma CA was measured by high performance liquid chromagraphy. AⅡ and ALD were measure by radioimmunoassay. Results:(1)Before treatment,the SBP/DBP increased 20.3%/20.4% during the handgrip test and HR increased 14.5%. After treatment, the SBP/DBP increased 7.8%/7.3% only( P <0.01) and HR increased 5.3% only( P <0.01). (2)After the ISR treatment ,the plasma norepinephrine(NE),AⅡ,ALD concentration and BP decreased substantially. Conclusion:Verapamil SR can decreas plasma concentration of NE, AⅡ, ALD. It can also decrease the SNS activity, thus the blood pressure will be decreased steadily.