缬沙坦对原发性高血压患者内皮素、醛固酮的影响和降压疗效观察

Effects of Valsartan on Plasma Aldosterone,Endothelin and its Antihypertension Efficacy

目的 :探讨缬沙坦对原发性高血压病患者内皮素和醛固酮的影响。方法 :45 2例原发性高血压患者随机分为两组 ,缬沙坦组 (治疗组 2 2 8例 ) :80～ 16 0mg/d口服 ,疗程半年 ;依那普利组 (对照 ,2 2 4例 ) :5～ 15mg/d口服 ,疗程半年。治疗前后做动态血压监测 ,测定醛固酮、内皮素等。结果 :治疗组降压总有效率为 72 % (16 4例 ) ;降压幅度 (mmHg)收缩压为 2 6 .7,舒张压为 14.3;谷 /峰比值 (收缩压 0 .81,舒张压 0 .82 )。分别与对照组总有效率 73%(16 4例 ) ;降压幅度 (mmHg)收缩压为 2 6 .3、舒张为 13.5 ,谷 /峰比值 (收缩压 0 .82 ,舒张压 0 .81)相似。两组治疗后 ,醛固酮、内皮素均降低且治疗组醛固酮降幅均较对照组显著 (P <0 .0 5 )。结论 :缬沙坦是一种安全、作用持续稳定、耐受性良好、不良反应轻微的治疗轻、中度原发性高血压病的新型降压药物。

Objective: To investigate the effects of Valsartan on plasma aldosterone and endothelin in patients with essential hypertension. Methods: 452 cases were randomly assigned into two groups. Patients in the first group(228 cases) were given 80 mg to 160mg of valsartan daily for six months . Those in the second group (224 cases) were given 5mg to 15mg of enalapfril daily for six months. The dynamic blood pressure was monitored and aldosterone(Ald) and endothelin (ET) were examined before and after the therapy. Results: The total effective rate,the reducing scope of SBP and DBP and the trough to peak ratio (T/P)of SBP and DBP in Valsartan group were 72%,26.7mmHg,14 3mmHg,0 81 and 0 82respectively,compared to 73%,26.3mmHg,13 5mmHg,0 82 and 0 81 respectively in enalapril group. Ald and ET decreased after the therapy in both groups ( P< 0 05),with the greater reduction of Ald in valsartan group ( P< 0 05).Conclusion Valsartan is a safe and reliable antihypertensive agent with good tolerance and mild side effects.