伊贝沙坦和苯那普利对肾素-醛固酮系统的影响  

Effect of Irbesartan and Benazeprial on Ras

作　　者：张朝阳[1] 孙兴昌 黄洁[1] 彭北阳 李一石[1] 

机构地区：[1]中国医学院科学院中国协和医科大学心血管病研究所阜外心血管病医院临床药理研究室,北京100037 [2]首都钢铁公司医务室

出　　处：《中国临床药理学杂志》2001年第2期94-95,共2页The Chinese Journal of Clinical Pharmacology

摘　　要：目的：研究伊贝沙坦及苯那普利对中国高血压病患者肾素－醛固酮系统（ＲＡＳ）的影响．方法：轻中度高血压患者６１例，停用各种抗高血压药一周后，给予普通饮食及安慰剂两周。所有患者随机分成两组，分别口服伊贝沙坦１５０－３００ｍｇ，苯那普利 １０～２０ ｍｇ，每日一次。两周随访一次，记录血压和不良反应，疗程８周，治疗前后各行坐位取血，按照标准离心，用放免法检测肾素活性，血管紧张素几醛固酮。结果：服伊贝沙坦组肾素活性，血管紧张素Ⅱ呈平行性增加。苯那普利组好素活性升高，血管紧张素Ⅱ水平下降。醛固酮在两组中均轻度下降，但无统计学意义。伊贝沙坦和苯那普利的降压效果相似，伊贝沙坦组药物不良反应较少。结论：每日一次日服伊贝沙坦 １５０～３００ｍｇ或苯那普利 １０～２０ ｍｇ，，其降压作用相似均可持续２４ｈ。伊贝沙坦使血浆肾素，血管紧张素Ⅱ呈平行性升高，而苯那普利使肾素活性升高，血管紧张素Ⅱ水平下降，说明其作用机制不同；伊贝沙坦较苯那普利的副作用少是其选择性ＡＴ１受体阻制作用所致。OBJECTIVE: To evaluate the effect of Irbesartan and benazepril on RAS in patients with essential hypertension. METHODS: Patients with mildmoderate hypertension were enrolled. After one week of withdrawal of all antihypertensive medications, normal salt diet and placebo was administrated for two weeks, then blood sample were collected for measurement of renin activity, angiotensin Ⅱ and aldosterone. All patients were divided randomly into two groups, irbesartan and benazepril were administrated respectively on dose of 150mg to 300mg and on dose of 10-20 mg once-daily for & weeks. During this period, all patients were visited once two weeks, blood pressures and side-effects being recorded , then renin activity, angiotensin Ⅱ and aldosterone were measured again. RESULTS: Irbesartan induce a parallel increment of renin and angiotensin. In benazepril group, renin activity increase, angiotensin Ⅱ level decrease. Aldosterone decrease insignificantly.in both groups. Comparison with benazepril, Irbesartan induce similar antihypertensive efficiency and less side-effect. CONCLUSION: Irbesartan on dose of 150-300mg and benazepril 10-20 mg once-daily achieve similar antihypertensive efficiency and maintains for more than 24 hours.Differing from benazepril which inhibit angiotensin-converting enzyme,lrbesartan exerts by blocking AT1 receptor. Irbesartan has less side-effect.due to its special selective AT1 receptor blocking.

关 键 词：伊贝沙坦 苯那普利 高血压 药物治疗 肾素-醛固酮系统 

分 类 号：R544.1[医药卫生—心血管疾病] R972.4[医药卫生—内科学]