福辛普利对原发性高血压患者降压作用和对内皮功能的影响

Effects of Monopril on Blood Pressure,Endothellal Function and Renin-Angiotensin system in Essential Hypertensive Patients

目的：评价福辛普利对轻、中度原发性高血压患者的降医疗效，以及对原发性高血压患者内皮功能和肾素一血管紧张素系统（ＲＡＳ）影响的机制。 方法：６０例原发性高血压患者，随机分为福辛普利组３０例和吲哒帕胺组３０例。观察治疗前与治疗后６周，诊所血压（ＣＢＰ）、血浆一氧化氮、内皮素、肾素活性、血管紧张素Ⅱ和醛固酮浓度变化，并对ＣＢＰ和ＲＡＳ、血压水平与内皮功能之间的相关性进行分析。 结果：治疗后 ２组血压水平显著下降，福辛普利组收缩压从 １６０±１４ ｍｍＨｇ降至 １４９±１３ｍｍＨｇ，舒张医从 ９６±７ｍｍＨｇ降至 ８４±６ ｍｍＨｇ，吲哒帕胺组收缩压从 １６１±１６ ｍｍＨｇ降至 １５４±１４ ｍｍＨｇ，舒张压从 ９４±６ ｍｍＨｇ降至 ８５±７ ｍｍＨｇ，差异有极显著性（Ｐ均＜０．００１）。福辛普利组血浆一氧化氮升高，肾素活性上升，内皮素下降，血管紧张素Ⅱ下降，醛固酮下降，差异有极显著性（Ｐ均＜０．００１），吲哒帕胺组上述参数未见明显变化（Ｐ均＞０．０５）。 结论：福辛普利对于轻、中度原发性高血压患者疗效显著，福辛普利降压同时能改善动脉内皮功能，降低ＲＡＳ活性。

Objective: To investigate the efficacy of monopril on hypertension and its mechanism of action on endothelial functinn and renin-angiotensin system (RAS) in hypertensive patients. Methods:Sixty hypertensive patients were randomly divided into monopril group (n= 30) and indapamide group (n = 30). The changes of blood pressure,nitrous oxide (NO),endothelin (ET),plasma renin activity(PRA),angiotension (Aug) Ⅱ and aldosterone were observed after six weeks of treatment. The relativity of clinical blood pressure (CBP) to RAS and CBP to endothelial function was analysed. Results:The blood pressure was decreased significantly after treatment in monopril group [systolic blood pressure (BP) from 160±１4 mmHg to 149±１3 mmHg(1 mmHg＝0. 133 kPa),diastolic BP from 96±7 mmHg to 84±6 mmHg, p<0. 001]and indapamide group (systolic BP from 16±16 mmHg to 154±14 mmHg,diastolic BP from 94±6 mmHg to 85±7 mmHg,p<0. 001). In monopril group,the levels of NO and PRA were increased significantly and the levels of ET、Ang Ⅱ and aldosterone were decreased significantly. In indapamide group, no significant changes were found of above indexes. Conclusions:Monopril was effective against mild or moderate hypertension. It also improved the endothelial function and decreased the activity of RAS.