心痛定对原发性高血压病人血浆肾上腺髓质素水平的影响

The Effects of Nifedipine on the Plasma Level of Adrenomedullin in Essential Hypertension Patients

应用放免法测定24例原发性高血压病人在应用心痛定治疗前后血浆肾上腺髓质素(ADM1-52)、内皮素(ET-1)、血管紧张素Ⅱ(ATⅡ)及降钙素基因相关肽(CGRP)水平的变化及它们的相关性,并推测它们在高血压发病机制中的作用。发现治疗前ADM(1-52)、ET-1、ATⅡ水平较正常人升高(P<0.05),CGRP下降(P<0.05)。ADM(1-52)与ET-1、ATⅡ、MAP呈正相关,与CGRP呈负相关。用心痛定治疗后,ADM(1-52)、ET-1、ATⅡ水平下降,CGRP水平升高。动物试验发现,随着细胞外CE^(2+)浓度的增加,ADM释放量也逐渐增加。结果提示,原发性高血压病人血浆ADM(1-52)的水平升高是多种因素引起的,是机体的一种防御反应,可拮抗血压过度升高。同时ADM(1-52)又与ET-1、ATⅡ、CGRP等血管活性物质形成了复杂的系统,参与了高血压的发病过程。

Methods and Results: The plasma levels of ADM (1-52), ET-1, ATII and CGRP in essential hypertension patients were assayed by RIA.The results showed that the levels of ADM,ET-1,and ATII were markedly higher than those of normal subjects (P<0.05) ,but CGRP levels was lower (P<0.05). There was a positive correlation between ADM (1-52) and ATII,the same correlation between ADM (1-52) and CGRP. The plasma level of ADM (1-52),ET-1,ATII decreased and CGRP level increased when the patients were treated with nifedipine. The release of ADM from rat aorta endothelial cells and vascular smooth muscle cells increased with the enhancing of the concentration of extracellular Ca2+ . Conclusions: The release of ADM in essential hypertension patients was caused by a few of reasons, including the increasing of MAP, ET-1, ATII levels and decreasing of CGRP level. The change of ADM plasma level was much important in preventing the over-increase of blood pressure and ADM played an important role in essential hypertension.