摘要
目的 :观察醛固酮拮抗剂———螺内酯对原发性高血压 (EH)患者心肌纤维化的影响。方法 :将 5 7例EH患者随机分为A组 (2 9例 ) :单用贝那普利 (10mg/d) ,B组 (2 8例 ) :等量贝那普利加螺内酯 (2 0mg/d)。应用放射免疫分析技术测血清Ⅲ型前胶原末端肽 (PⅢP)、Ⅳ型前胶原末端肽 (PⅣP)含量 ;采用多普勒超声心动图仪测定左室结构及舒缩功能变化。结果 :两组患者治疗 6个月后 ,平均动脉压、PⅢP、PⅣP及室间隔舒张末期厚度、左室后壁厚度、左室重量指数较治疗前均有下降 (P <0 .0 5或 <0 .0 1) ,以B组下降更明显 ;舒张末期左室内径A组治疗前后无变化 (P >0 .0 5 ) ,B组治疗后有所下降 (P <0 .0 5 ) ;两组治疗后二尖瓣血流舒张早期流速和心房收缩期流速之比均有上升 (P <0 .0 5或 <0 .0 1) ,以A组上升更明显 (P <0 .0 5 ) ;左室收缩功能指标治疗前后无明显变化。两组治疗后均无明显副作用发生。结论 :EH患者在接受血管紧张素转换酶抑制剂治疗同时 ,再联用螺内酯 ,能更完全抑制肾素 血管紧张素 醛固酮系统 ,避免“醛固酮逃逸”现象 ,显著减轻心肌纤维化程度 。
Objective:To explore the effects of aldosterone antagonism spironolactone on cardiac fibrosis in patients with essential hypertension.Methods:The 57 patients with EH were randomly divided into two groups: Benazepril(10 mg/d)group(n=29); Spironolactone(20 mg/d)+Benazepril(10 mg/d)group(n=28). Serum contents of PⅢP,PⅣP were measured by radiommunoassay(RIA) before and after six months of treatments. Doppler ultrasound recordings were obtained from all patients before and after six months of treatments to determine several parameters relating to the left ventricular anatomy and function.Results:By six months treatments, two groups patients mean blood pressure(MBP), PⅢP, PⅣP, LVMI, IVSD, LPWD were significantly decreased than these before treatments, especially in Spironolactone+benazepril group; there were not significant changes about EF and FS before and after treatments; there were significant increased about VE/VA in two groups after six months treatments, it was more significantly in Spironolactone+Benazepril group than Benazepril group (P< 0.05 ). The adverse effects were not significant.Conclusion:Spironolactone help not only reducing blood pressure but also preventing cardiac fibrosis in patients with EH, additive effects were obvious when Spironolactone and Benazepril were combined.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2003年第8期466-468,共3页
Journal of Clinical Cardiology
关键词
高血压
螺内酯
Ⅲ型前胶原
Ⅳ型前胶原
心肌重构
Hypertension
Spironolactone
Pro collagen III
Pro collagen Ⅳ
Myocardial remodeling
