氢氯噻嗪长期联用卡托普利对高血压患者肾素-血管紧张素-醛固酮系统及生化指标的影响  

Effects of Long-term Treatment with Hydrochlorothiazide Combined Captopril on Variety of Renin-angiotensin-aldosterone System and Biochemical Parameters in Hypertensive Patients

作　　者：王丽晔[1] 李云[2] 吴寿岭[1] 李冬青[1] 邢爱君[1] 杜鑫[1] 王黎光[1] 宋绍敏[1] 侯国盛[1] 于清[1] 刘福山[1] 袁宝军[1] 李金萍[1] 

机构地区：[1]华北煤炭医学院附属开滦医院心内科,河北唐山063000 [2]华北煤炭医学院预防医学系,河北唐山063000

出　　处：《中国慢性病预防与控制》2009年第5期487-489,共3页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨氢氯噻嗪(HCTZ)与卡托普利长期联合治疗对高血压患者肾素-血管紧张素-醛固酮系统(RAAS)活性及生化指标的影响。方法在9所开滦矿区医院筛选出轻、中度高血压患者,在2周洗脱期和6周HCTZ(12.5mg,1次/d)导入期后加服卡托普利(25mg,2次/d),治疗5a。于洗脱期末、导入期末、治疗2a和5a时检测RAAS活性,每年检测血生化指标,比较各时间点RAAS活性变化与生化指标变化。结果6周HCTZ导入期末,患者血浆血管紧张素Ⅱ(AngⅡ)和醛固酮(ALD)浓度较基线值升高,差别有统计学意义(P<0.01),血钠浓度下降(P<0.01);治疗2a时血浆AngⅡ、ALD和血钠浓度已恢复至基线水平,血糖浓度下降(P<0.01);治疗5a后,血钾浓度下降(P<0.01),而血糖、血钠、AngⅡ、ALD浓度变化与基线值比较,差别无统计学意义(P>0.05)。结论高血压患者长期合用HCTZ与卡托普利治疗后,RAAS活性可恢复至治疗前水平,对血糖浓度影响不大,而血钾降低。Objective To explore the effects of long-term treatment with hydrochlorothiazide combined Captopril on variety of renin-angiotensin-aldosterone system and biochemical parameters in hypertensive patients. Methods A muhicenter study was performed and nine Kai-luan coal mining industry hospitals took part in the trial. After 2-weeks placebo elution period and 6- weeks hydrochlorothiazide leading period, the eligible patients with mild-moderate hypertension received hydrochlorothiazide （HCTZ, 12.5 mg, qd. ）and Captopril（25 mg, bid ） for 5 years. The activity of RAAS and biochemical parameters were measured at the end of placebo elution period, 6 weeks leading period, 2 years and 5 years. Analysis was performed between the variety of RAAS and biochemical parameters. Results At the end of 6 weeks hydrochlorothiazide leading period, plasma angiotensin- Ⅱ （Ang Ⅱ ）and aldosterone （ALD） concentrations in the patients was significantly higher （P〈0.01） while serum sodium was lower （P〈0.05）. After 2 years treatment, plasma Ang Ⅱ , ALD and concentrations had restored to baseline level while glucose levels were significantly reduced compared with the levels of baseline. After 5 years treatment, compared with baseline level, potassium were significantly reduced（P〈0.01 ）while Ang Ⅱ, ALD and glucose were no difference. Conclusion Activity of RAAS would restore to the levels of baseline after long-term treatment with hydrochlorothiazide combined Captopril and there are no significant effects of variety of RAAS on glucose. However, potassium was reduced.

关 键 词：肾素-血管紧张素-醛固酮系统 血糖 血钾 

分 类 号：R544.1[医药卫生—心血管疾病]