细胞内游离钙、血压变异性在氯沙坦逆转高血压左心室肥厚中的作用

Effect of intracellular free calcium concentration and blood pressure variability on reversion of left ventricular hypertrophy by losartan therapy in essential hypertension

目的 探讨原发性高血压 ( EH)患者淋巴细胞内胞浆游离钙浓度 ( [Ca2 + ] i)、血压变异性 ( BPV)与氯沙坦逆转高血压左心室肥厚作用的关系。方法 选择 EH患者 60例 ,予氯沙坦治疗 6个月 ,治疗前后检测 [Ca2 + ] i、BPV及左心室重量指数 ( LVMI)。结果 经氯沙坦治疗后 ,EH患者淋巴细胞内 [Ca2 + ] i 从治疗前的 10 2 .3± 11.84nmol/ L降至 84.64± 9.5 2 nmol/ L( P<0 .0 1) ,LVMI从治疗前的 15 5 .69± 2 1.75 g/ m2降至 13 5 .85± 13 .66g/ m2 ( P<0 .0 0 1) ,BPV亦显著下降 ( P<0 .0 1)。 [Ca2 + ] i 的下降幅度与 LVMI的下降幅度呈显著正相关 ( r=0 .6675 ,P<0 .0 5 )。结论 氯沙坦能降低高血压病患者的 BPV,逆转高血压左心室肥厚 ,其逆转左心室肥厚的作用可能与降低血管紧张素 引起的 [Ca2 + ] i

Objective To investigate the effect of intracellular free calcium concentration and blood pressure variabi lity (BPV) on reversion of left ventricular hypertrophy by losartan therapy in essential hypertension(EH).Methods Sixty cases with EH were treated with losartan for six months, intralymphocytic free calcium concentration (\[Ca 2+ \] i), left ventricular mass index(LVMI) were measured before and after trearment. Results After 6 months of treatment with losartan,concentration of \[Ca 2+ \] i in EH patients reduced from 102.2±11.84nmol/L befor treatment to 84.64±9.52nmol/L( P <0.01), LVMI from 155.69±21.75g/m 2 befor treatment to 135.85±13.66g/m 2,( P <0.001) and BPV were significantly decreased( P <0.01). There was a positive correlation between the changes of \[Ca 2+ \] i and LVMI ( r =0.667 5, P <0.05). Conclusion Losartan therapy could decrease the BPV and reverse left ventricular hypertrophy in essential hypertension patients which may be related with losartan decrea sing elevated level of \[Ca 2+ \] i induced by AT Ⅱ.