阿罗洛尔及咪唑普利对高血压病患者利钾尿肽与心钠素比值的影响

Effect of arotinolol and imidapril on the molar ratio of kaliuretic peptide/atrial natriuretic peptide in the treatment of elderly essential hypertension

目的 探讨利钾尿肽 (KP)与心钠素 (ANP)比值在老年高血压病治疗中的作用。方法将 60例老年高血压病患者随机分为两组 ,分别给予阿罗洛尔 (2 0～ 30mg/d)、咪唑普利 (5～ 1 0mg/d)治疗 6周 ,并检测治疗前后血浆中KP与ANP的浓度。结果 治疗前与对照组比较 ,高血压病患者血浆KP、ANP水平升高 ,KP/ANP比值降低 (P <0 0 0 1 )。治疗后两组患者血压均明显下降 (P <0 0 0 1 ) ,组间差异无显著性 (P >0 0 5)。阿罗洛尔组血浆KP、ANP水平升高 ,咪唑普利组下降 ,两组KP/ANP比值均升高 (P <0 0 0 1 )。结论 KP含量及KP/ANP比值的改变 ,在老年高血压病治疗中起着一定的作用。

Objective To investigate the role of the molar ratio of kaliuretic peptide/atrial natriuretic peptide in the treatment of elderly essential hypertension(EH) Methods Sixty patients with mild to moderate essential hypertension were randomized into two groups and treated with arotinolol (20 30mg/d) and imidapril (5 10mg/d) respectively The plasma levels of kaliuretic peptide (KP) and atrial natriuretic peptide (ANP) were measured before and after treatment Results Compared with the control group, the plasma levels of KP and ANP in the EH groups were increased significantly KP was in grade Ⅰ (308 3±21 4 vs 287 3±27 4 pmol/L, P <0 001) and in grade Ⅱ (337 2±28 5 vs 287 3±27 4 pmol/L, P <0 001) and ANP in grade Ⅰ(92 1±18 2 vs 70 1±18 7pmol/L, P <0 001)and in grade Ⅱ (92 1±18 2 vs 125 4±27 4 pmol/L, P <0 001) respectively However, the molar ratio of KP/ANP in the two grades were lowered(3 34±1 1 vs 4 1±0 8 P <0 001, 2 7±1 0 vs 4 1±0 8, P <0 001 respectively) After six weeks monotherary, the two drugs induced significant reduction in blood pressure( P <0 001) and the reduction of each group was similar compared to each group( P >0 05) The levels of KP and ANP were increased in the arotinolnol group (KP:313 3 ±25 9 vs 418 4±26 4pmol/L, P <0 001; ANP:90 1±19 9 vs 107 3±22 3pmol/L, P <0 001 respectively) and lowed in the imidapril group(KP:312 1±23 1 vs 277 6±36 2pmol/L, P <0 001, ANP:94 7±20 3 vs 70 8±18 3, P <0 001 respectively) In the two groups,the molar ratio of KP/ANP was increased (imidapril:3 3±0 5 vs 4 0±0 7, P <0 001, arotinolnol:3 4±0 8 vs 3 8±0 8, P <0 001) significantly Conclusion KP and the molar ratio of KP/ANP may play an important role in the treatment of elderly essential hypertension