高血压病左室肥厚病人苯那普利治疗后血浆肾上腺髓质素、内皮素水平变化

Changes of Plasma Adrenomeduelin and Endothelin Levels and Effect of Benazepril in Hypertension with Left Ventricular Hypertrophy

目的 探讨高血压病及左室肥厚患者血浆肾上腺髓质素 (AM )、内皮素 (ET)水平的变化 ,以及苯那普利对AM、ET浓度的影响。方法 44例高血压病患者 ,应用超声心动仪测定左室后壁厚度 (LVPWT)和室间隔厚度(IVST) ,依据左室肥厚的诊断标准分为左室肥厚组 (LVH) 2 8例 ,无左室肥厚组 (NLVH) 16例。正常对照组 2 8例。应用放射免疫分析法测定苯那普利治疗前后血浆AM、ET水平的变化。结果 高血压组AM、ET水平分别为 35 1±7 3、78 0± 4 9(ng/L) ,明显高于对照组的 16 5± 3 4、5 4 6± 9 8(ng/L) (P <0 0 1)。LVH组分别为 37 8± 8 1、84 2± 6 3(ng/L) ,明显高于NLVH组 31 6± 3 0、6 8 6± 7 9(ng/L) (P <0 0 1)。高血压组苯那普利治疗后 2 2 9± 5 3、6 5 0± 1 0 (ng/L) ,明显低于治疗前 35 1± 7 3、78 0± 4 9(ng/L) (P <0 0 1) ,差异显著 ,有统计学意义。高血压Ⅰ、Ⅱ、Ⅲ级患者的AM、ET含量与高血压严重程度呈正相关。结论 AM、ET水平与血压升高及升高程度密切相关 ,苯那普利能在有效降压同时 ,明显降低AM、ET水平。AM作为心肌细胞的自分泌或旁分泌因子调节心肌细胞生长 ,在左室肥厚的发生和发展中起重要的作用。

Objective To investigate the changes of plasma adrenomeduelin(AM), endothelin(ET) and the effect of benazepril in hypertensive patients with LVH. Methods LVPWT and IVST were measured using echocardiography in 44 cases hypertension patients (LVH 28 cases, NLVH 16 cases) and 28 cases as controls. Plasma AM, ET concentrations were studied before and after benazepril treatment by radioimmunoassay. Results Plasma AM and ET were significantly higher in hypertensives than those of control(AM:35.1±7.3 vs 16.5±3.4 ng/L; ET: 78.0±4.9 vs 54.6±9.8 (ng/L). In hypertension with LVH, AM and ET were significantly higher than those with NLVH(AM:37.8±8.1 vs 31.6±3.0 ng/L; ET:84.2±6.3 vs 68.6±7.9 ng/L). Furthernore, they were decreased after benazepril treatment (AM: from 35.1±7.3 to 22.9±5.3 ng/L; ET from 78.0±4.9 to 65.0±1.0 ng/L). Am and ET were positively related to the stages of hypertension. Conclusions Plasma AM and ET were positively correlated with BP. Benazepril can reduce the plasma levels of AM and ET along with the decrease in BP.