钙拮抗剂干预对高血压合并左心室肥厚的影响  

Effect of chacium channel blocker on left ventricular hypertrophy in essential hypertensives

作　　者：高东升[1] 魏广和[1] 张金国[1] 董殿阶[1] 刘立新[1] 

机构地区：[1]济宁医学院附属医院,山东济宁272129

出　　处：《山东医药》2004年第1期20-21,共2页Shandong Medical Journal

摘　　要：目的　探讨钙拮抗剂非洛地平逆转高血压 (EH )合并左心室肥厚 (L VH )的作用及其机制。方法　选择 EH合并 L VH的患者 30例 ,测定非洛地平治疗 (5～ 10 mg/ d) 2 4周前后左室重量指数 (L VMI)、胰岛素敏感指数 (ISI)及血浆肾素活性 (PRA)、血管紧张素 (Ang )、醛固酮 (AL D)、内皮素 (ET)、一氧化氮 (NO)、去甲肾上腺素 (NE)水平。结果　非洛地平治疗后 ,L VMI减小 (P<0 .0 1) ,ET降低 (P<0 .0 5 ) ,NO、ISI升高 (P均 <0 .0 1) ,而 PRA、Ang 、AL D、及 NE无显著变化。结论　钙拮抗剂非洛地平可以逆转 EH合并 L VH,其机制可能与非洛地平改善内皮细胞功能和胰岛素抵抗 ,而对肾素 -血管紧张素 -醛固酮系统 (RAAS)及交感神经系统 (SYS)Objective To investigate the mechanism of the reversal effect of felodipine on left ventricular hypertrophy(LVH)in patients with essential hypertension(EH).Methods Left ventricular mass index(LVMI),the levels of plasma renin activity(PRA),angiotensin Ⅱ(AngⅡ),aldosterone(ALD),endothelin(ET),nitric oxide(NO),norepinephrne(NE)and insulin sensitive index(SIS)were determined in 30 EH patients with LVH before and after administered felodipine(5～10mg/d,orally)for 24 weeks.Results After treatment,LVMI and the levels of ET were reduced obviously(P<0.01,P<0.05).ISI and the levels of NO were increased significantly(P<0.01).But the level of PRA,Ang Ⅱ,ALD and NE had no change.Conclusion Felodipine can reverse LVH and EH,it might be mediated by improving endothelial dysfunction and insulin resistance and not activating the rein-angiotensin-aldosterone system and the sympathetic nervous system.

关 键 词：钙拮抗剂 高血压 合并症 左心室肥厚 药物治疗 

分 类 号：R544.1[医药卫生—心血管疾病] R542.2[医药卫生—内科学]