培哚普利对原发性高血压患者循环一氧化氮/内皮素平衡的影响

Effect of perindopril on the balance of nitric oxide and endothelin in blood of patients with essential hypertension

目的 :探讨血压与循环一氧化氮 ( NO) /内皮素 ( ET)的关系及培哚普利对其影响。方法 :应用 Griess、放免法观察培哚普利治疗前、后 30例原发性高血压 ( EH)患者循环 NO/ ET的变化 ,并与 2 5例健康者对照。结果 :NO与 ET比值 ( NO/ ET) :EH组治疗前较对照组明显减低 ( P <0 .0 1) ,而治疗后则较治疗前有明显升高 ( P <0 .0 5 )。平均血压 ( MBP) :EH组治疗前明显高于对照组 ( P <0 .0 1) ,而治疗后则较治疗前明显下降 ( P <0 .0 1)。各组 MBP与 NO/ ET呈显著负相关(对照组 r =- 0 .5 81、 P <0 .0 1,EH组治疗前 r =- 0 .35、 P <0 .0 5 ,治疗后 r =- 0 .5 0 5、 P <0 .0 1)。结论 :EH患者循环 NO/ ET失衡 ,与血压呈负相关 ,可能参与高血压维持与发展。培哚普利改善 NO/ ET失衡 ,与血压下降平行 ,可能是培哚普利降压机制的另一重要方面。

Objective:To evaluate the effects of perindopril on the balance of NO/ET in blood of patients with essential hypertension (EH).Method:The alteration of balance of NO/ET were respectively observed by Griess method,radioimmunoassay in all subjects,including 25 control subjects and 30 EH patients before (EHB) and after (EHA) one month therapy with perindopril (EH group).Result:The ratio of NO/ET was significantly lower in EHB group than in control group (P< 0.01 ),and higher in EHA group than in EHB group (P< 0.05 ).Mean blood pressure (MBP) was higher in EHB group than in control group (P< 0.01 ),but lower in EHA group than in EHB group (P< 0.01 ).The ratio of NO/ET was inversely related to MBP in all groups (control:r= -0.581 P< 0.01 ,EHB:r= -0.35 P< 0.05 ,EHA:r= -0.505 P< 0.01 ).Conclusion:The results suggest that the imbalance of NO/ET is present in blood of patients with EH,which negatively related to MBP,may play an important role in sustaining and developing of hypertension.Perindopril reverses the imbalance of NO/ET and speculate that this action may be an important aspect of its antihypertensive mechanism.