Losartan逆转钙超负荷及对高血压肾的保护作用

Protective role of losartan in reversion of hypertensive calcium overload and glomerular injury

目的 :探讨外周血细胞内钙浓度与高血压、血管和肾小球病变之间的关系。方法 :动物分自发性高血压 (SHR)组和正常对照血压 (WKY鼠 )组 ,其中SHR组再分为治疗组 (予losartan 2 0mg·kg-1·d-1)和非治疗组 ,分别于 3、8月龄测量鼠尾动脉压、外周血淋巴细胞内游离钙浓度及电子显微镜下血管、肾脏有关病理指标。结果 :与同龄正常对照组比较 ,早期高血压鼠外周血淋巴细胞内游离钙浓度已增高 ,病理表现为血管内皮损伤 ,管腔表面粗糙变形、内皮细胞增殖肥大 ,而肾小球内未见明显细胞增生改变 ,但基底膜有轻度增厚和系膜扩张。 8月龄时血管、肾小球细胞均明显肥大 ,且与钙浓度升高呈密切相关。而经losartan治疗后 ,SHR钙超负荷得到逆转 ,血压显著下降 ,血管、肾小球损伤得到修复。结论 :高血压钙超负荷现象不但与血压、血管改变相关 ,而且与肾小球损害也密切相关 ,并能通过外周血细胞内钙浓度来反映其变化 ,losartan能逆转高血压鼠的钙超负荷现象 ,降压同时 。

AIM: To investigate the relation between cytosolic calcium and glomerular injury in hypertension. METHODS: The normotensive control (WKY) and spontaneously hypertensive rat group(SHR) with or without treatment (losartan 20 mg·kg -1 ·d -1 ) were compared. Intralymphocytic free calcium level and ultrastructural changes in glomerulus were observed at three and eight months, respectively. RESULTS: The results demonstrated early impairment in glomerulus and elevation of cytosolic calcium at three months in SHR group, at eight months, aggravation of impairment in glomerulus correlating with calcium elevation was shown. Losartan significantly attenuated the above pathologic changes. CONCLUSION: Calcium-overload state was not only related to blood pressure and vessel impairment, but also associated with glomerular injury, which could be reversed by losartan.