厄贝沙坦氢氯噻嗪对高血压患者的作用机制研究及其对肾功能的影响  

Mechanism and renal function of irbesartan hydrochlorothiazide on patients with essential hypertension

作　　者：刘必铿[1] 庄伟[2] 林金秀[1] 

机构地区：[1]福建医科大学附属第一医院药剂科,福州350005 [2]福建医科大学附属第一医院心内科,福州350005

出　　处：《中国临床药理学杂志》2015年第21期2089-2092,共4页The Chinese Journal of Clinical Pharmacology

基　　金：福建省科技计划基金资助项目(2014Y0019)

摘　　要：目的探讨厄贝沙坦氢氯噻嗪对高血压患者血压、心率、血清炎症因子、同型半胱氨酸、内皮素、血液动力学及肾功能的影响。方法 166例原发性高血压患者随机分为试验组和对照组,各83例。对照组给予常规治疗,试验组在常规治疗基础上口服厄贝沙坦氢氯噻嗪,包括厄贝沙坦150 mg和氢氯噻嗪12.5 mg,每日1次,治疗期间若患者症状改善不明显,加用药物剂量为厄贝沙坦300 mg和氢氯噻嗪25 mg。2组均治疗12周。统计2组血压、心率、血清炎症因子、同型半胱氨酸、内皮素、血流动力学及肾功能水平变化。结果 2组治疗后血压、心率均明显低于治疗前(P<0.05),试验组显著低于对照组(P<0.05)。试验组治疗后C-反应蛋白、细胞间黏附分子、白细胞介素-6水平明显低于治疗前和对照组(P<0.05)。2组治疗后同型半胱氨酸、内皮素水平明显低于治疗前(P<0.05),试验组显著低于对照组(P<0.05)。治疗后,试验组全血低切黏度、全血高切黏度、血浆黏度水平明显低于治疗前和对照组(P<0.05)。治疗后,2组血肌酸酐、尿素氮明显低于治疗前(P<0.05);试验组治疗后显著低于对照组(P<0.05)。结论厄贝沙坦氢氯噻嗪可明显降低高血压患者血压、心率、血清炎症因子、同型半胱氨酸、内皮素、血流动力学及肾功能水平,从而改善患者症状。Objective To investigate the effect of irbesartan hydrochlo-rothiazide on blood pressure, heart rate, serum inflammatory factors, ho-mocysteine（Hcy）, endothelin, hemorheology and renal function in pa-tients with essential hypertension.Methods A total of 166 patients with essential hypertension were randomly divided into treatment group and control group, each was 83 cases.The control group received convention-al treatment, treatment group received irbesartan hydrochlorothiazide 150 mg/12.5 mg on the basis of control group, qd, when there was no obvious improvement, added the dose to 250 mg/25 mg.Both groups were treated for 12 weeks.The blood pressure, heart rate, serum inflam-matory factors, Hcy, endothelin, hemorheology and renal function levels were observed of the two groups.Results After treatment, the blood pressure and heart rate of the two groups were significantly lower than be-fore treatment （ P〈0.05 ）; treatment group was significantly lower than control group （ P 〈0.05 ） .After treatment, the C -reactive protein,＆amp;nbsp;intercelluar-adhesion molecule（ ICAM-1） , interleukin-6 levels in treatment group were significantly lower than be-fore treatment and control group （P〈0.05）.After treatment, the Hcy, endothelin levels were significantly lower than before treatment, and treatment group were lower than control group （ P〈0.05）.The low shear whole blood viscosity, high shear whole blood viscosity, plasma viscosity in treatment group after group were significantly lower than before treatment and control group（P〈0.05）.The levels of serum creatine and blood urea nitrogen after treatment were sig-nificantly lower than before treatment （ P〈0.05 ） , and treatment group were significantly lower than control group （P〈0.05）.Conclusion Irbesartan hydrochlorothiazide can significantly decrease the blood pressure, heart rate, se-rum inflammatory factors, Hcy, endothelin, hemorheology and renal function in patients with with essential hyperten-sion, thereby improvin

关 键 词：厄贝沙坦氢氯噻嗪 高血压 血清炎症因子 同型半胱氨酸 内皮素 血流动力学 肾功能 

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