安体舒通对血压控制平稳的高血压患者胶原代谢的影响  

Effects of Spironolactone on Collagen Metabolism in Hypertensive Patients with Controlled Blood Pressure

作　　者：邱恒霞[1] 林海龙[1] 陈淑敏[1] 张静[1] 潘晓芳[1] 顾宇[1] 徐鹤[1] 贺业健[1] 

机构地区：[1]大连市中心医院心内科,辽宁大连116033

出　　处：《中华高血压杂志》2007年第6期456-459,共4页Chinese Journal of Hypertension

基　　金：2006年度大连市卫生局科研课题

摘　　要：目的观察安体舒通对已控制血压的高血压患者胶原代谢的影响。方法选取已控制血压的原发性高血压患者45例,随机分为对照组和安体舒通组。对照组继续原降压方案治疗,安体舒通组在原降压治疗方案基础上加用安体舒通20mg/d治疗,观察6月。所有患者均在治疗前、后应用超声心动图测定左心室质量指数(LVMI),应用放免技术测定Ⅰ、Ⅲ型胶原血清代谢性标记Ⅰ型前胶原氨端肽(PⅠNP)、Ⅲ型前胶原(PCⅢ)和Ⅰ型胶原C端绞链肽(ⅠCTP)。结果治疗后两组血压皆有下降趋势,但未达统计学差异,各相同观察时点两组间血压比较亦无差异。安体舒通组治疗后的LVMI明显低于治疗前(P<0.05),治疗后安体舒通组与对照组比较LVMI亦明显降低(P<0.05)。与治疗前比较,安体舒通组治疗后血清的PCⅢ、PⅠNP的浓度皆明显降低(P<0.01),但ⅠCTP浓度无变化(P>0.05);治疗后安体舒通组与对照组比较,血清的PCⅢ、PⅠNP的浓度皆明显降低(P<0.01),但ⅠCTP浓度无变化(P>0.05)。结论安体舒通可以抑制血压控制平稳的高血压患者的胶原合成,但可能对其胶原的降解影响不大。安体舒通的这一作用与降压无关,可能属非压力相关性获益。Objective To study the effect of spironolactone on collagen metabolism in essential hypertensive patients with controlled blood pressure. Methods Forty-five essential hypertensive outpatients whose blood pressures had been controlled to normal level were randomly to receive standard ant＋hypertensive treatment （control group n=23） or spironolactone （20 mg/d, n=22） for 6 months. Echocardiography was performed to determine left ventricular mass index （LVMI）. The serum level of collagen metabolic markers： N-terminal propeptide of type Ⅰ collagen （P Ⅰ NP） and procollagen of type Ⅲ （PCⅢ） and C-terminal telopeptide of type Ⅰ collagen （ CTP） were determined by radioactive immunoassay. Results Blood pressure was decreased similarly in both two groups. After 6 months treatment, spironolactone significantly decrease LVMI than that of control （107.0 ± 18. 0 vs 120. 7±19.9 g/m^2 , P〈0.05）, as were serum concentration of PCⅢ and P Ⅰ NP （ PCⅢ , spironolactone： 77. 6±18 vs control： 97.6±19.3 μg/L; PⅠ NP, Spironolactone： 38.9±6.0 vs 50. 1±10.6 μg/L, all P〈0.01）, while no difference in ICTP was found between them （P〉0.05）. Conclusion Spironolactone reduces collagen synthesis, but not affect collagen degradation in essential hypertensive patients. The beneficial effect of spironolactone on collagen metabolism are independent of blood pressure.

关 键 词：原发性高血压 安体舒通 胶原代谢 

分 类 号：R544.1[医药卫生—心血管疾病]