摘要
目的探讨不同联合降压治疗对原发性高血压左心室肥厚(LVH)患者血浆基质金属蛋白酶9(MMP-9)和基质金属蛋白酶组织抑制物1(TIMP-1)的影响。方法入选原发性高血压LVH患者51例(男28例,女23例),年龄(61.8±7.0)岁,随机分为低剂量氨氯地平(2.5mg/d)加替米沙坦(40mg/d)组(n=26)和氨氯地平(2.5mg/d)加复方阿米洛利(半片/d)组(n=25),治疗1年。于治疗前后分别检测左心室质量指数(LVMI)、血浆MMP-9和TIMP-1等,并进行比较分析。52例体检健康者作为对照组,其中男28例,女24例,年龄(61.2±5.5)岁。结果原发性高血压LVH患者MMP-9、TIMP-1浓度较正常健康者明显升高(均P<0.05)。氨氯地平加替米沙坦组和氨氯地平加复方阿米洛利组患者基线临床特征相似,血压分别为(153.2±8.9)/(95.2±4.8)和(151.3±8.7)/(94.8±3.3)mmHg,LVMI分别为(129.5±16.3)和(127.6±17.3)g/m2,血浆MMP-9浓度分别为(81.8±23.4)和(80.3±22.2)μg/L,血浆TIMP-1浓度分别为(429.1±43.5)和(449.2±50.6)μg/L。降压治疗1年后氨氯地平加替米沙坦组与氨氯地平加复方阿米洛利组血压分别降至(126.0±9.9)/(73.6±7.2)和(129.8±5.5)/(79.2±5.3)mmHg;LVMI分别降至(91.7±16.9)和(104.7±16.3)g/m2;血浆MMP-9浓度分别为(65.3±19.9)和(68.1±19.4)μg/L;血浆TIMP-1浓度分别为(488.2±44.4)和(486.1±59.1)μg/L,两组数据与治疗前比较均有明显差异(均P<0.05)。结论以钙拮抗剂为基础的联合降压治疗可通过降低血压和影响MMP/TIMP酶系统逆转LVH。
Objective To investigate the effects of different antihypertensive therapies on concentrations of plasma matrix metallopeptidase 9（MMP-9） and tissue inhibitor of metalloproteinases 1（TIMP-1） in hypertensive patients with left ventricular hypertrophy（LVH）.Methods Fifty-one hypertensive patients with LVH [male 28,female 23,average age （61.8±7.0）] were randomly assigned to receive low-dose amlodipine（2.5 mg/d）plus telmisartan（40 mg/d）[male 14,female 12,average ages（62.2±6.8）] or low-dose amlodipine（2.5 mg/d）plus compound amiloride（0.5 tablet/d）[male 14,female 11,average ages（63.4±7.3）].All the patients were followed-up for 1 year.Baseline and one year left ventricular mass index （LVMI） were examined,and the concentrations of plasma MMP-9 and TIMP-1 were detected respectively.Fifty-two healthy individuals were taken as control.Results The concentrations of plasma MMP-9 and TIMP-1 in hypertensive LVH patients were significantly higher than those in control （all P0.05）.Mean blood pressure,LVMI,the plasma MMP-9 and TIMP-1 at baseline were similar between amlodipine with telmisartan and amlodipine with amiloride group,they are （153.2±8.9）/（95.2±4.8） vs （151.3±8.7）/（94.8±3.3） mm Hg,（129.5±16.3） vs （127.6±17.3） g/m2,（81.8±23.4） vs （80.3±22.2） and（429.1±43.5） vs （449.2±50.6）μg/L respectively.After 1 year treatment,in amlodipine with telmisartan group and amlodipine with amiloride group,the blood pressure was reduced to （126.0±9.9）/（73.6±7.2） and （129.8±5.5）/（79.2±5.3）mm Hg,LVMI to（91.7±16.9） and（104.7±16.3）g/m2,respectively.The concentrations of plasma MMP-9 and TIMP-1 were （65.3±19.9）vs （68.1±19.4）,（488.2±44.4） vs （486.1±59.1） μg/L respectively,which differ significantly from baseline （all P0.05）.Conclusion CCB-based antihypertensive combination therapy could reverse LVH though decreasing blood pressure and altering MMP/TIMP enzyme systems.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2010年第9期869-874,共6页
Chinese Journal of Hypertension
基金
国家"十一五"科技支撑计划课题(2006BAI01A03)
国家自然科学基金资助项目(No.30871042)
关键词
高血压
左心室肥厚
基质金属蛋白酶9
基质金属蛋白酶组织抑制物1
Hypertension
Left ventricular hypertrophy
Matrix metallopeptidase 9
Tissue inhibitor of metalloproteinases 1
