高血压病不同血压分级患者血浆内皮素和降钙素基因相关肽变化及非洛地平对其影响

Endothelin and calcitonin gene related peptide in patients with essential hypertension of different blood pressure grades and their changes after felodipine treatment.

目的 探讨原发性高血压 (EH)患者不同血压水平与血浆内皮素 (ET)和降钙素基因相关肽 (CGRP)浓度之间的关系以及非洛地平对其浓度的影响。方法 将 86例住院 EH患者 ,按 1999年 WHO/ ISH标准高血压分级为 1级 2 8例、2级 36例、3级 2 2例。健康对照组 30例。所有 EH患者在非洛地平治疗前、后进行 2 4小时动态血压监测、血浆 ET和CGRP浓度的测定。结果 EH患者血浆 ET水平明显高于对照组 ,CGRP水平明显低于对照组 (均 P<0 .0 1) ,随着 EH血压分级的增高。ET水平增高、CGRP水平降低 (均 P<0 .0 5～ 0 .0 1)。非洛地平治疗后 ,EH患者血压和血浆 ET明显下降、CGRP明显增高 (P<0 .0 1)。结论 EH患者血浆 ET和 CGRP含量与血压水平密切相关 ,非洛地平降压疗效确切 ,并能降低患者血浆 ET、升高 CGRP。

Objective To assess endothelin(ET)and calcitonin gene related peptide(CGRP)in patients with essential hypertension(EH)of different blood pressure grades and their changes after felodipine treatment.Methods The study was carried out on 86 patients with EH.According to the 1999 WHO/ISH Guidelines for the Management of Hypertension,these patients with EH were divided into three groups:grade one (n=28),grade two (n=36),and grade three(n=22).Besides these,30 healthy subjects were recruited as normal controls.All patients with EH were under felodipine treatment.The 24h ambulatory blood pressure(ABP),ET and CGRP levels were measured before and after treatment.Results The plasma level of ET was significantly higher in EH group than in normal group( P <0.01);the plasma level of CGRP was significantly lower in EH group than in normal group( P <0.01).Further analysis of the EH patients revealed:the higher the blood pressure grade scaled,the higher would be the plasma level of ET but the lower would be the plasma level of CGRP ( P <0.05～0.01).And after felodipine treatment,the blood pressure and the plasma level of ET were significantly decreased and the plasma level of CGRP was increased in EH patients ( P <0.01).Conclusion These data demonstrate that plasma levels of ET and CGRP are closely associated with the blood pressure grade in EH patients.Felodipine has good effect on hypertension;it decreases ET and increases CGRT in EH patients.