缬沙坦和吲哒啪胺对高血压病患者细胞因子影响的对比研究(英文)  

Effects of valsartan and indapamide on plasma cytokines in essential hypertension

作　　者：谢启应[1] 王庸晋[2] 孙泽琳[1] 杨天崙[1] 

机构地区：[1]中南大学湘雅医院心血管内科,长沙410008 [2]长治医学院附属和平医院心血管内科,山西长治046000

出　　处：《中南大学学报（医学版）》2006年第5期629-634,共6页Journal of Central South University ：Medical Science

基　　金：This work was supported by a grant from"The Scientific Research Foundation of SanitaryGovernment of Hunan Province (C2005-011)"

摘　　要：目的:比较吲达帕胺和缬沙坦治疗对高血压病患者外周血中细胞因子单核细胞趋化因子-1(MCP-1)、巨噬细胞炎性蛋白1α(MIP-1α)、可溶性P选择素(sP-selectin)、非对称二甲基精氨酸(ADMA)、血管紧张素Ⅱ(AngⅡ)和6-酮-PGF1α(6-keto-PGF1α)的影响。方法:选取我院门诊健康体检者20例和41例原发性高血压患者,将41例高血压患者随机分为吲哒啪胺组(20例)和缬沙坦组(21例),分别予吲哒啪胺(商品名钠催离)1.5mg/d和缬沙坦(商品名代文)80mg/d治疗4周,治疗前和治疗4周后抽血检测MCP-1,MIP-1α,sP-selectin,ADMA,AngⅡ和6-keto-PGF1α含量。结果:同正常血压组相比,高血压病患者外周血中MCP-1,MIP-1α,sP-selectin,ADMA浓度显著增加。吲哒啪胺组治疗前后MCP-1,MIP-1α和sP-selectin浓度无明显变化;而缬沙坦治疗4周后,MCP-1,MIP-1α和sP-selectin浓度与治疗前相比均显著下降分别为(19.16±3.11)pg/mLvs(16.08±2.67)pg/mL,P<0.05;(27.74±8.36)pg/mLvs(17.64±7.59)pg/mL,P<0.05;(2.67±3.18)pg/mLvs(6.15±2.94)pg/mL,P<0.01。吲达帕胺和缬沙坦治疗后,ADMA浓度均下降分别为(1.35±0.74)μmol/Lvs(0.98±0.56)μmol/L,P<0.05;(1.31±0.68)μmol/Lvs(0.71±0.52)μmol/L,P<0.01,而6-keto-PGF1α浓度增加,但在缬沙坦组增高更加显著分别为(61.96±20.81)pg/mLvs(96.72±25.89)pg/mL,P<0.05;(63.25±16.92)pg/mLvs(143.22±43.45)pg/mL,P<0.01。两组治疗前后AngⅡ无显著变化。结论:轻中度高血压病患者外周血中细胞因子MCP-1,MIP-1α,sP-selectin和ADMA的浓度增加;缬沙坦和吲哒啪胺具有相似的降压疗效,同时还可降低上述细胞因子水平。Objective To investigate and compare the effect of valsartan and indapamide on inflammatory cytokines in hypertension. Methods Forty-one untreated patients with mild to moderate hypertension and 20 age- and sex-matched normotensives were enrolled in this study. Hypertensives were treated with indapamide 1.5 mg/d （ n = 20） or valsartan 80 mg/d （ n = 21 ） for 4 weeks, and blood samples for determining monocyte chemotactic protein-1 （MCP-1）, macrophage inflammatory protein-1 （MIP-1α）, sP-selectin, asymmetric dimethylarginin （ ADMA）, angiotensin Ⅱ （ Ang Ⅱ ）, and 6-keto-PGF1 α were collected before the treatment and 4 weeks after the treatment. Results Hypertensives exhibited significantly higher blood pressure, as well as elevated plasma levels of MCP-1, MIP-lα, sP-selectin and serum level of ADMA compared with the normotensives. Nevertheless, there was no significant difference in serum 6-keto-PGF1 α and Ang Ⅱ between the hypertensives and the normotensives After the treatment with indapamide or valsartan for 4 weeks, both the systolic and diastolic blood pressures, though still higher than those of the normotensives, decreased markedly. After the treatment with indapamide for 4 weeks, MCP-1, MIP-1 α and sP-selectin slightly decreased, but not statistically significant （ P 〉 0.05 ）. Those cytokines decreased significantly after being treated with valsartan for 4 weeks [ （ 19.16 ±3.11 ） pg/mL vs （ 16.08±2.67 ） pg/mL, P〈0.05; （27.74±8.36） pg/mL vs （17.64 ±7.59） pg/mL, P〈0.05; （2.67 ±3. 18） pg/mL vs （6.15±2.94） pg/mL, P 〈0.01 ]. In the 2 treatment groups, 6-keto-PGF1α markedly increased [ （61.96 ± 20.81 ） pg/mL vs （96.72 ±25.89） pg/mL, P 〈0.05 ; （63.25 ± 16.92.） pg/mL vs （ 143.22±43.45 ） pg/mL, P 〈0.01 ] ; ADMA decreased significantly [ （ 1.35 ± 0.74） pg/mL vs （ 0.98± 0.56 ） μmol/L, P 〈 0.05 ; （ 1.31 ± 0.68） pg/mL vs （0.71 ± 0.52）μmoL/L, P 〈 0.01 ]. Though Ang Ⅱ slightly increased, no statis

关 键 词：高血压 细胞因子 缬沙坦 吲哚啪胺 血管紧张素Ⅱ 

分 类 号：R544.1[医药卫生—心血管疾病]