芦沙坦、氨氯地平对轻、中度原发性高血压患者血小板活化和肾功能的影响

Effect of Losartan and Amilodipine on Platelet Activation and Renal Function in Patients with Mild and Moderate Essential Hypertension

研究芦沙坦、氨氯地平对原发性高血压 (EH)患者血小板活化与肾功能的影响 ,并探讨血小板活化与高血压性肾损害的关系。方法将 6 6例 1～ 2级EH患者随机分为 2组 ,分别接受芦沙坦、氨氯地平治疗 3个月 ,用药前后测尿白蛋白排泄率 (UAER) ,血浆α颗粒膜蛋白 (GMP 14 0 )、尿素氮 (BUN )、血肌酐 (Cr)、肌酐清除率 (CCR)。结果①治疗后 2组血压均明显下降 ;②GMP 14 0 ,UAER均显著下降 (P<0 .0 0 1) ,BUN ,CCR均无明显变化 ;③治疗前后UAER与GMP 14 0呈显著正相关 (r =0 .6 8和r =0 .49) ,与血压下降之间无显著相关。结论①芦沙坦、氨氯地平均能有效控制血压、减轻早期高血压性肾损害 ;②二药可能通过抑制血小板活化对肾功能起到保护作用。

ObjectiveTo evaluate the effects of losartan and amilodipine on platelet activation and renal function,and study the relationship between platelet activation and hypertensive renal damage in patients with mild and moderate essential hypertension(EH).MethodsSixty-six patients with mild and moderate EH were randomly divided into two groups:losartan or amilodipine was given for three months respectively.Urinary albumin excretion rate(UAER),plasma α-granule membrane protein-140(GMP-140),blood urea nitrogen(BUN),blood creatinine(Cr)and creatinine clearance (CCr) were measured before and after the treatment.ResultsThe blood pressure,GMP-140,UAER decreased significantly in both groups after the treatment(P< 0.01).It was found that a clear positive correlation existed between the levels of GMP-140 and UAER before and after the treatment in EH patients(r=0.68 and 0.49),but there was no significant positive correlation between the levels of UAER and decreased blood pressure after the treatment.ConclusionThe blood pressures of patients with mild and moderate EH were well controlled and their renal function improved during the treatment with losartan or amilodipine.the latter protective effect was partly attributed to their inhibition on platelet activation. [