氨氯地平联合替米沙坦对高血压左心室肥厚患者血浆Ⅰ、Ⅲ型胶原代谢标记物的影响  

Effects of amlodipine combined telmisartan on plasma collagen types Ⅰ and Ⅲ metabolism products in essential hypertensive patients with left ventricular hypertrophy

作　　者：卢群[1] 鲁敏[1] 韩克[1] 田刚[1] 

机构地区：[1]西安交通大学第一附属医院心血管内科,陕西710061

出　　处：《中华高血压杂志》2011年第3期257-262,共6页Chinese Journal of Hypertension

基　　金：国家十一五科技支撑计划--高血压综合防治研究(2006BAI01A03);国家自然科学基金资助项目(30871042)

摘　　要：目的观察小剂量氨氯地平联合替米沙坦对高血压左心室肥厚(LVH)患者Ⅰ、Ⅲ型胶原血浆代谢标记物Ⅰ型前胶原羧基末端肽(PⅠCP)和Ⅲ型前胶原氨基末端肽(PⅢNP)的影响。方法入选单纯高血压患者76例(单纯高血压组),男40例,女36例,年龄(60.5±6.5)岁。高血压LVH患者79例(高血压LVH组),其中男41例,女38例,年龄(60.7±7.1)岁,随机分为氨氯地平(2.5mg/d)组(n=25),替米沙坦(40mg/d)组(n=28),氨氯地平加替米沙坦联合用药(2.5mg/d+40mg/d)组(n=26),治疗1年。于治疗前后分别检测左心室质量指数(LVMI)、血浆PⅠCP和PⅢNP浓度等,并进行比较分析。72例体检健康者作为对照组,其中男38例,女34例,年龄(58.4±4.6)岁。结果高血压LVH患者PⅠCP、PⅢNP浓度较正常健康者和单纯高血压患者明显升高(均P<0.05)。氨氯地平组、替米沙坦组和联合用药组患者基线血压、室间隔厚度(IVST)、LVMI、血浆PⅠCP和PⅢNP浓度等临床特征相似(均P>0.05)。与治疗前比较发现,降压治疗1年后氨氯地平、替米沙坦和氨氯地平联合替米沙坦均能有效控制血压(均P<0.05),降低IVST、LVMI和左心室后壁厚度(LVPWT)(均P<0.05),同时血浆PⅠCP和PⅢNP浓度亦均降低(均P<0.05)。联合用药组在血压下降幅度、降低LVMI和血浆胶原代谢标记物浓度等方面均优于单药组(均P<0.05)。结论氨氯地平联合替米沙坦通过有效控制血压和降低血浆Ⅰ、Ⅲ型胶原代谢标记物浓度逆转高血压患者LVH,其效果优于两药单用。Objective To analyze the effects of amlodipine combined telmisartan on plasma collagen types Ⅰ and Ⅲ metabolism products carboxy-terminal propeptide of type Ⅰ procollagen（PⅠCP）and amino-terminal propeptide of type Ⅲ procollagen（PⅢNP）in essential hypertensive patients with left ventricular hypertrophy（LVH）.Methods Seventy-six hypertensive patients were taken as hypertensive group.79 hypertensive patients with LVH [male 41,female 38,average age（60.7±7.1）years] were randomly assigned to amlodipine（2.5 mg/d）group（n=25）,telmisartan（40 mg/d）group（n=28）and amlodipine（2.5 mg/d）combined telmisartan（40 mg/d）group（n=26）.72 healthy individuals were taken as control.All the hypertensive LVH patients were followed-up for one year.Baseline and one year left ventricular mass index（LVMI）were examined,and plasma PⅠCP and PⅢNP were detected respectively.Results The concentrations of plasma PⅠCP and PⅢNP in hypertensive LVH patients were significantly higher than those in control respectively（all P0.05）.The clinical characteristics such as mean blood pressure,interventricular septal thickness（IVST）,LVMI,the levels of plasma PⅠCP and PⅢNP at baseline were similar among amlodipine group,telmisartan group and amlodipine combined telmisartan group（all P0.05）.After one year treatment,the blood pressure were controlled significantly in each group respectively（all P0.05）.IVST,LVMI and left ventricular posterior wall thickness（LVPWT）,the levels of plasma PⅠCP and PⅢNP were decreased respectively,which differ significantly compared with baseline（all P0.05）.The combination group was better than the monotherapy in decreasing blood pressure,LVMI,the levels of plasma PⅠCP and PⅢNP（all P0.05）.Conclusion The combination of amlodipine and telmisartan was better than the monotherapy in attenuating LVH,which was associated with decreased blood pressure and inhibited plasma collagen types Ⅰ and Ⅲ metabolism products.

关 键 词：高血压 左心室肥厚 氨氯地平 替米沙坦 胶原 

分 类 号：R544.1[医药卫生—心血管疾病]