氨氯地平对高血压患者心肾功能的影响及其与细胞内胞浆游离钙的关系

The Relationship between Intracellular Free Calcium Concentration and the Effect of Amlodipine on Heart and Renal Functions in Essential Hypertensive Patients

目的 :探讨氨氯地平对原发性高血压 (EH)患者心肾功能的影响及其与细胞内胞浆游离钙 ([Ca2 + ]i,)的关系。方法 :选择EH患者 90例 ,予氨氯地平治疗 6个月 ,治疗前后检测淋巴细胞内 [Ca2 + ]i 进行 2 4h动态血压监测 ,检测左室重量指数 (LVMI) ,左室舒张功能和肾功能指标。结果 :经氯沙坦治疗后 ,[Ca2 + ]i,日间、夜间和 2 4h收缩压和舒张压 ,LVMI和 2 4h尿蛋白均显著下降 (P <0 .0 1) ,左室舒张功能显著改善 (P <0 .0 5 )。 [Ca2 + ]i,的下降幅度与LVMI的下降幅度呈正相关 (r =0 .6 5 2 2 ,P <0 .0 5 ) ,[Ca2 + ]i 的下降幅与E/A比值的上升幅度呈负相关 (r=- 0 .5 2 3,P <0 .0 5 )。结论 :氨氯地平通过纠正细胞内钙代谢紊乱而平稳降压、逆转左室重构和阻断钙在肾功能损害中的媒介作用 ,达到保护心肾功能的目的。

Objective:To investigate the relationship between intracellular free calcium concentration and the effect of amlodipine on heart and renal functions in essential hypertensive patients.Methods:90 cases of essential hypertensive patients were treated with amlodipine for six months,intralymphocytic free calcium concentration([Ca 2+ ] i),ambulatory blood pressure monitoring(ABPM),left ventricular mass index(LVMI),left ventricular function and parameters of renal function were measured before and after treatment.Result:After 6 months of treatment,[Ca 2+ ] i,ABPM,LVMI and 24 hour micro albuminuria were significantly decreased( P <0.01),and left ventricular function significantly decreased( P <0.05).There was a positive correlation between the changes of [Ca 2+ ] i and LVMI (r=0.6522,P <0.05),also a negative correlation between the changes of [Ca 2+ ] i and E/A ratio(r=0.523, P <0.05).Conclusion:The mechanisms of antihypertensive effect and improvement of heart and renal functions by amlodipine therapy might be associated to normalization of intracellular calcium metabolism.