氯沙坦对高血压病患者肾素血管紧张素系统及血管内皮功能的影响

The Effects of losartan on renin-angiotensin system and vascular endothelial function in patients with essential hypertension

目的 探讨氯沙坦对高血压病患者血浆肾素活性 (PRA)、血管紧张素Ⅱ (ANGⅡ )、内皮素 (ET 1)和血清醛固酮 (ALD)、肿瘤坏死因子 (TNF α)的影响。方法 68例高血压病患者给予口服氯沙坦 ( 5 0～ 10 0mg·d-1,部分病例加用氢氯噻嗪 12 .5～ 2 5mg·d-1) 2 0周 ,观察患者血压的变化 ,并应用放射免疫分析法观察治疗前后患者PRA、ANGⅡ、ET 1和ALD、TNF α的变化。结果 患者的收缩压、舒张压、血浆ALD、ET 1、TNF α明显下降 (均P <0 .0 0 1) ,而血浆PRA、ANGⅡ明显上升 (均P <0 .0 0 1)。结论 氯沙坦可以显著改善高血压病患者的内皮功能 。

Objective To investigate the effects of losartan on renin-angiotensin system(RAS) and vascular endothelial function in patients with essential hypertension.Methods Sixty-eight patients with essential hypertension were treated with losartan(50?～100?mg·d -1) for 20 weeks.If nessary hydrochlorothiazide(12.5～25?mg·d -1)was added.The sitting systolic and diastolic blood pressure(SBp and DBp) were observed,and the levels of serum or plasma renin activity(PRA),angiotensin Ⅱ(ANG II),endothelin?1(ET?1),aldosterone(ALD),tumor necrosis factor-α(TNF-α)were measured by radioimmunoassay before and after treatment.Results SBp and DBp,the levels of ET?1,TNF?α and ALD were decreased significantly after treatment (all P<0.001).PRA and ANG Ⅱwere elevated significantly after treatment (all P<0.001).Conclusion Losartan can improve the endothelial function of hypertensive patients and decrease the serum ALD level.