姜黄素对原发性高血压患者肾素-血管紧张素-醛固酮系统及血管内皮功能的影响

Effect of curcumin on renin-angiotensin-aldosterone system and vascular endothelial function in patients with essential hypertension

目的研究姜黄素对原发性高血压患者肾素-血管紧张素-醛固酮系统及血管内皮功能的影响。方法选择2017年3月至2018年9月于山西省人民医院确诊的接受钙通道阻滞剂或无药物治疗的原发性高血压患者131例为研究对象。随机分为治疗组66例、对照组65例。2组均予继续原降压治疗方案(服用原钙通道阻滞剂或不服药)常规治疗,治疗组在常规治疗基础上加用姜黄素胶囊口服,疗程均为12周,分别于治疗前后采集空腹血液样品,采用放射免疫法测定血浆肾素活性(PRA)、血管紧张素Ⅱ(Ang-Ⅱ)和血浆醛固酮浓度(PAC),利用内皮功能检测仪器测定反应性充血指数(RHI),2组于治疗前后均行24 h动态血压检查。结果治疗组治疗前后比较立位PRA、立位Ang-Ⅱ、立位PAC、RHI及24 h平均收缩压差异均有统计学意义(P<0.05)。而对照组治疗前后各项指标均差异无统计学意义。结论姜黄素可以有效降低原发性高血压患者立位PRA、Ang-Ⅱ紧张素、PAC及24 h平均收缩压水平,同时可改善其血管内皮功能。

Objective To investigate the effect of curcumin on renin-angiotensin-aldosterone system and vascular endothelial function in patients with essential hypertension(EH).Methods A total of 131 patients with EH,who received calcium channel blockers or failed drug therapy in Shanxi Provincial People′s Hospital between March 2017 and September 2018 were included as the subjects in the study.All patients were randomly divided into the study group(n=66)and control group(n=65).Both groups were treated with conventional antihypertensive therapy(with oral conventional calcium channel blockers or without medication),while the study group was additionally given oral Curcumin capsules for 12 weeks.The fasting blood samples were taken at the baseline and after the treatment,respectively.Plasma renin activity(PRA),angiotensinⅡ(Ang-Ⅱ)and plasma aldosterone concentration(PAC)levels were determined by radioimmunoassay.The reactive hyperemia index(RHI)was measured by an endothelial function testing instrument,and the 24-hour ambulatory blood pressure in the two groups were examinedat the baseline and after the treatment.Results There were statistically significant differences in the PRA(in upright position),Ang-Ⅱ(in upright position),PAC(in upright position),RHI,and 24-hour mean systolic blood pressure in the study group at the baseline and after the treatment(P<0.05).There were no statistically significant differences in the indexesin the control group at the baseline and after the treatment.Conclusion Curcumin may effectively reduce the level of renin-angiotensin-aldosterone and 24-hour mean systolic blood pressure in EH patients in upright position,and improve vascular endothelial function.