氨氯地平和依那普利对高血压大鼠肾损害的防治效果观察  

Prevention and treatment of nephrotic damage in spontaneous hypertension rats

作　　者：牟善初[1] 宁兆琪[1] 王喜群[1] 余霞君[1] 

机构地区：[1]解放军总医院南二科,北京市100853

出　　处：《中华老年医学杂志》2000年第1期41-44,共4页Chinese Journal of Geriatrics

摘　　要：目的　探讨钙拮抗剂氨氯地平 ( amlodipine)与转换酶抑制剂依那普利 ( enalapril)抗高血压治疗时对肾脏的保护作用。　方法　实验动物为 1 6月龄的自发性高血压大鼠 ( SHR) 3 0只 ,分为氨氯地平组、依那普利组及对照组 ,治疗及观察时间为 3个月。　结果　氨氯地平和依那普利降压效果相似 ,肾功能改变 :老化过程中对照组内生肌酐清除率 ( Ccr)为 ( 0 .0 90± 0 .0 1 0 ) ml· min- 1 ·1 0 0 g- 1体重 ,与实验前的 ( 0 .1 4 9± 0 .0 0 7) ml·min- 1· 1 0 0 g- 1体重比较显著降低 ( P<0 .0 1 ) ;两治疗组 Ccr无明显下降 ( P>0 .0 5) ,依那普利组为 ( 0 .1 57± 0 .0 0 3 ) ml· min- 1 · 1 0 0 g- 1 体重 ,氨氯地平组为 ( 0 .1 63± 0 .0 0 6) ml·min- 1· 1 0 0 g- 1体重。肾功能测验 ,N-乙酰 -β-D-氨基葡萄糖苷酶在对照组逐步增高 ,但两治疗组降低。血浆血管紧张素 水平与肾组织内皮素含量 :依那普利组〔( 2 52 .3± 3 3 .1 )ng/ L、( 1 2 2 .2± 3 3 .5) ng/ L〕与氨氯地平组〔( 1 87.3 2± 53 .1 ) ng/ L、( 1 51 .1± 2 2 .9) ng/ L〕均低于对照组〔( 3 83 .5± 84 .1 ) ng/ L、( 1 85.8± 1 4 .5) ng/ L〕( P<0 .0 1 )。肾病理改变 ,对照组明显重于治疗组。计算机图像分析 。Objective To study the protective effect of antihypertensive therapy with calcium channel antagonist (CCA) ——amlodipine and ACEI——enalapril. Methods Thirty spontaneous hypertension rats (SHR) were divided equally into three groups. The first group was treated with amylodipine, the second with enalapril and the third with placebos to serve as control. All were observed carefully for three months. Results The antihypertensive effect was noticed similarly in both the treated groups. There was marked change of renal function in the control group〔(0 090±0 010)ml·min -1 ·100g -1 bw〕as shown by a significant decline of endogenous clearance rate (Ccr) in the course of senescence.There was no such decline in the enalapril treated group 〔(0 158 ±0 003)ml·min -1 ·100g -1 bw〕and even slight improvement in the amylodipine treated group〔(0 163 ±0 006)ml·min -1 ·100g -1 bw〕. The amount of N acetyl D glucosaminidase (NAG) enzyme was gradually elevated in the control group, but lowered in both the treated groups. The plasma ATⅡlevels of the treated groups were lower than that of the control. The content of endothelin in the renal tissue was apparently lower in both the enalapril group〔(122 2±33 5)ng/L, P <0 01〕 and amylodipine group〔(151 1±22 9) ng/L, P <0 05〕than that in the control group〔(185 8±14 5)ng/L〕. The pathological change of the kidney is much striking in the control group than that in the treat-ed groups. Computor assisted images showed much higher relative mesenchymal matrix in the control group. Conclusions Both enalapril and amylodipine could effectively control hypertension and prevent the decline of renal function of the SHR. Both drugs could exert therapeutic role by means of controlling high blood pressure, preventing decline of renal function and relieving glomerular sclerosis and renal stromal fibrosis.

关 键 词：高血压 肾功能衰竭 依那普利 氨氯地平 

分 类 号：R544.1[医药卫生—心血管疾病]