运动激发及转换酶抑制剂对RAS作用机制探讨  

Study on the Mechanism of Effect of Angiotensin Converting Enzyme Inhibitor on Renin-angiotensin System while Undergoing Bicycle Exercise Test

作　　者：吴顺娣[1] 郭冀珍[1] 宋代军[1] 张桂生[2] 刘国明[2] 龚兰生[1] 

机构地区：[1]上海第二医科大学附属瑞金医院,上海市高血压研究所200025 [2]上海第二医科大学科技中心实验室

出　　处：《上海第二医科大学学报》1997年第2期81-84,共4页Acta Universitatis Medicinalis Secondae Shanghai

基　　金：国家自然科学基金!39170848

摘　　要：作者选择10例原发性高血压患者与8例正常人，观察在运动激发状态及服血管紧张素转换酶抑制剂（ACEI）依那普利前后，血管紧张素Ⅱ（AugⅡ）、血浆肾素活性（PRA）、ACE、尿白蛋白排泄率（UEA）及尿缓激肽（BK）的变化，以探讨RAS在高血压发病中的作用。结果显示：1.服依那普利后血ACE在静息及运动状态都明显被抑制（P＜0．05），但AngⅡ不被抑制；2.服依那普利使血压和UEA明显减少但不能阻断运动所致AngⅡ的升高；3．运动后的尿BK，在EH和NS两组均明显下降，但不受依那普利影响。提示：全身RAS与KKS参与了ACEI的作用，但肾及血管局部RAS具有重要的作用。To evaluate the role of renin-angiotensin system(RAS) on pathogenesis of essential hypertension(EH), 10 patients with EH and 8 normal subjects(NS) as controls were studied for the changes of plasma renin activity (PRA), angiotensin Ⅱ (Ang Ⅱ), an giotensin -converti n g enzyme (ACE), urinary excretion of albumine (UEA) and bradykinin (UBK) while undergoing bicycle exercise before and after the administration of Enalapril. The results showed: (1) Plasma ACE was inhibited significantly after the administration of Enalapril during both rest and exercise conditions (P<0.05,P<0.05, repectively), but AngⅡ did not decrease in EH group, suggesting that other mechanisms,besides RAS and kallikrein-kinins system (KKS), may be involved in the antihypertensive effect of ACEI. (2)The changes of UAE and SBP, DBP all decreased significantly following the administration of Enalapril after exercise (△ UEA:P<0.05; △ SBP:P<0.001, △ DBP:P<0.005). Therefore,it is possible that local interenal and blood vessel RAS might play more important role than the circulating RAS in EH and the antihypertensive effect of ACEI. (3)The levels of UBK decreased significantly after exercise in both EH and NS groups(P<0.05,P<0.05, respectively), but they were not effected by Enalapril, further suggesting the participation of other mechaniams, not related to RAS.

关 键 词：高血压 血管紧张素 转换酶抑制剂 运动负荷试验 

分 类 号：R544.102[医药卫生—心血管疾病]