摘要
目的观察血管紧张素Ⅱ(AngⅡ)AT1受体拮抗剂对AT1受体自身抗体阳性的难治性高血压合并糖耐量减低(IGT)患者降压疗效。方法应用ELISA技术检测237例人血清抗AT1受体自身抗体,其中难治性高血压病合并IGT患者91例(为A组),非难治性高血压病伴IGT患者106例(为B组),健康对照组40例(为C组)。A组中AT1受体自身抗体阳性者39例为A1治疗组,阴性者52例为A2对照组,两组均给予口服:尼群地平10mg/tid;氢氯噻嗪12.5mg/d;肠溶阿斯匹林100mg/d;缬沙坦160mg/d;卡托普利25mg/tid。正常对照组40例。结果①难治性高血压合并IGTAT1受体自身抗体阳性率为57.1%(52/197),明显高于非难治性高血压伴IGT的15.1%和正常对照组的12.5%,比较具有统计学意义。②难治性高血压合并糖耐量减A1组降压疗效明显优于A2组,两组比较具有显著性统计学意义(P<0.05)。③临床降压效果评定,A1组总有效率为84.6%,明显高于A2组51.9%,两组比较具有极显著性意义(P<0.01)。结论对难治性高血压合并糖耐量减低,通过抗AT1受体自身抗体检测,有针对性选择降压药物缬沙坦且降压安全有效。
Objective To investigate the effects of valsartan on the patients with the positive AT1-adrenergic receptor and refractory hypertension with impaired glucose tolerance （IGT）. Methods The epitopes of the second extracellular loop of AT1 receptor （165-191） was synthesized and used respectively to screen sera autoantibodies from patients with refractory hypertension with IGT （n = 91, group A）, patients with no refractory hypertension with IGT （n = 106, group B） and healthy blood donors （n = 40, control） by enzyme-linked irnmunosorbent assay （ELISA）. Group A was divided two groups, i.e. the therapy group （A1 patients with the positive autoantibodies against AT1 receptor, n = 39） and the control group （A2, patients with the negative autoantibodies against AT1 receptor, n = 52）. Patients were given the following drugs respectively. Valsartan 160mg·d^-1 , Aspilin 100mg·d^-1, Nitrendipine 10mg tid, Hydrochlorothiazide 12. 5 mg·d^-1 , Captopril 25mg tid. Results （1） In patients of refractory hypertension with IGT, the rate of positive autoantibodies against AT1 receptor was 57.1%（52/197）, higher than that of no refractory hypertension with IGT （15.1%, 16/ 106） and healthy blood donors （12.5%,5/40）. （2） Effects of Valsartan treatment were significantly better in group A1 than in group A2 （P〈0. 05）, （3） The total effective rate of group A1 （84. 6%） was higher than that of group A2 （51.9%） （P〈0.01）. Conclusion The autoantibodies against AT1 receptor may play important roles in the pathogenesis of refractory hypertension with IGT. Valsartan can significantly improve the therapy effect in patients with refractory hypertension with IGT and with positive autoantibodies against AT1 receptor.
出处
《华南国防医学杂志》
CAS
2008年第2期30-34,共5页
Military Medical Journal of South China
基金
湖北省自然科学基金项目(2002AB116)
关键词
难治性高血压并糖耐量减低
AT_1受体自身抗体
降压治疗
Refractory hypertension with impaired glucose tolerance
Autoantibodies against AT1 receptor
Treatment of hypertension
