疏血通注射液联合卡托普利片对老年高血压患者血管活性物质的影响及其肾脏保护作用

Effects of Shuxuetong Injection and Captopril on Vasoactive Substances in the Elderly Hypertensive Patients and Its Renal Protective Mechanism

目的观察疏血通注射液联合卡托普利片对老年高血压患者立位肾素(PRA)活性、血管紧张素Ⅱ(AngⅡ)、内皮素(ET)、一氧化氮(NO)含量及尿微量蛋白的影响,探讨疏血通注射液的降压机制及肾脏保护作用。方法将老年高血压病患者随机分为治疗组(40例)和对照组(36例)。治疗组采用疏血通注射液联合卡托普利片治疗,对照组单用卡托普利片治疗,14d为一疗程。观察治疗前后患者血压,血浆PRA、ET、AngⅡ、NO,尿微量蛋白及其他生化指标的变化。结果治疗组患者各时段收缩压和舒张压水平明显下降(P<0.05);治疗组血浆ET、AngⅡ水平降低,PRA、NO水平升高(P<0.05),血浆ET、NO、PRA水平变化与对照组比较有统计学意义(P<0.05);血浆AngⅡ水平变化与对照组比较无统计学意义(P>0.05)。尿微量白蛋白、尿β2-微球蛋白排出量显著降低,疗效优于对照组(P<0.01)。治疗组血液流变学及血脂水平较治疗前明显改善,与对照组比较差异显著(P<0.01)。结论疏血通注射液对老年高血压患者血管活性物质有明显改善作用,可降低血压,对老年高血压患者肾脏有很好的保护作用。

Objective To explore the effect of Shuxuetong injection（SXTI） and captopril on the activity of PRA and the content of angiotensin Ⅱ （Ang Ⅱ）, endothelial prime （ET）, nitric oxide （NO）, urine microprotein in the elderly hypertensive patients and its renalprotective mechanism. Methods Seventy - six elderly patients with hypertension were randomly divided into two groups;The control group（n=36） treated with captopril, and the treatment group（n = 40）treated with captopril and SXTI for 14 days. Blood Pressure, PRA, ET, Ang Ⅱ , NO, urine microprotein and the other biochemical data were observed before and after the treatment. Results The level of SBP and DBP decreased significantly in each period in the treating group （P〈0.01）. The level of ET and Ang Ⅱ was descending, and the level of PRA,NO was ascending in the treating group （P^0.01）. There was a significant difference compared with the control group for the level of ET, NO, PRA（P〈0.05）. The difference of the level of Ang ]I was insignificant. The output of urine microalbuminuria and urine beta 2 - micro globulin decreased significantly,the treatment group being better than the control group （P〈0.01）. The hemorheological characteristics and lipids in the treating group were improved obviously,and the difference was significant compared with the control group（P〈0.01）. Conclusion SXTI could significantly improve vasoactive substances,hemorheological characteristics,endothelial function,lower blood pressure and lipids and protect renal function in elderly patients with hypertension. Key words： Shuxuetong injection; geriatric hypertension ; vasoactive substances; urine microprotein