培哚普利与硝苯地平对老年高血压患者纤溶系统及血管活性物质的干预  

Comparison of perindopril and nifedipin SR effect on the fibrinolytic system and other vasoactvators in elderly hypertensives

作　　者：黄林喜[1] 林鹏洲[1] 陈妙英[1] 

机构地区：[1]汕头大学医学院第一附属医院急诊科,广东汕头515041

出　　处：《中国基层医药》2004年第9期1051-1052,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　比较培哚普利与硝苯地平对老年原发性高血压患者纤溶系统及其他血管活性物质的影响。方法　 6 8例老年原发性轻、中度高血压患者随机给予培哚普利 (4mg ,1次 /d)或缓释硝苯地平 (2 0mg ,2次 /d)治疗 8周。治疗前后测定血压、心率 ,并测定血组织型纤溶酶原激活物 (tPA)、纤溶酶原激活物抑制剂(PAI) 1、纤维蛋白原 (FIB)、血管紧张素 (Ang)Ⅱ、血管紧张素转换酶 (ACE)及去甲肾上腺素 (NE)浓度。结果　培哚普利和缓释硝苯地平治疗后血压均有所下降 ,收缩压 /舒张压降幅平均为 11 5 / 5 8mmHg和 17 9/6 6mmHg。缓释硝苯地平组收缩压下降更显著 ,心率较前增加 (P <0 0 5 )。两组基线tPA和PAI 1浓度相似 (P >0 0 5 )。血浆PAI 1在培哚普利治疗后下降 2 6 % (P <0 0 5 ) ,而缓释硝苯地平治疗后增加 2 8% (P <0 0 5 ) ,组间比较差异有显著意义 (P <0 0 1)。而对于tPA和FIB ,两组治疗前后差异均无显著意义 (P >0 0 5 )。两组基线血清ACE、AngⅡ和血浆NE浓度差异无显著意义。培哚普利治疗后血清ACE和AngⅡ显著下降 ,组间比较差异有显著意义 (P <0 0 5 ) ;而缓释硝苯地平治疗后血浆NE增加 ,组间比较差异有显著意义 (P <0 0 5 )。结论　同缓释硝苯地平相比 ,培哚普利能降低老年高血压患者PAI 1,增?Objective To compare the effects of perindopril and nifedipin SR on the fibrinolytic system and other vasoactvators in elderly patients with essential hypertension.Methods 68 elderly patients with mild to moderate essential hypertension in outpatient were randomly divided into perindopril(4mg qd) group or nifedipine SR(20mg,bid) group for 8 weeks.Blood pressure,heart rate,plasma tPA,PAI-1,fibrinogen,serum angiotensin Ⅱ,ACE and plasma noradrenalin were measured before and after treatment.Results Blood pressure were decreased significantly in both groups,while HR was increased by nifedipine SR.The baseline tPA and PAI-1 were similar between the two groups.Plasma PAI-1 was significantly reduced in the group treated with perindopril,but increased in the nifedipine SR group after treatment.tPA and FIB were not changed in both groups.In addition,perindoprilsignficantly reduced serum ACE and angiotensin Ⅱ,while nifedipine SR increased plasma noradrenalin concentration.Conclusion Compared with nifedipine SR,perindopril significantly reduced PAI-1 and increased the fibrinolytic activity and decreased serum angiotensin Ⅱ via inhibition of serum ACE in elderly hypertensives.While sympathetic nerve activity was increased by nifedipine SR.When selecting antihypertensives drugs for patients at a high risk of thrombosis,great attention must be paid to their effect on the fibrinolytic system.

关 键 词：培哚普利 缓释硝苯地平 治疗后 患者 纤溶系统 PAI-1 血管活性物质 

分 类 号：R544.1[医药卫生—心血管疾病] R541[医药卫生—内科学]