ACEI治疗肾性高血压和对肾机能的保护作用

为观察血管紧张素转换酶抑制剂 (ACEI)对肾性高血压患者血浆ET 1,NO水平和对肾机能的影响 ,采用每日 1次ACEI制剂洛丁新 10mg治疗肾性高血压患者 10周 ,观察治疗前、后血浆ET 1,NO水平及肾机能指标的变化。结果示 :治疗前肾性高血压组血浆ET 1水平明显高于正常对照组 ,而NO水平明显低于正常对照组 ,经ACEI治疗后高血压组血浆ET 1较治疗前明显降低 (P <0 .0 1) ,NO较治疗前明显升高 (P <0 .0 1) ,尿蛋白排泄显著减少 (P<0 .0 1)。肾机能异常组血BUN降低 (P <0 .0 5 ) ,Scr明显降低 (P <0 .0 1)。提示 :ACEI可调节血浆ET 1及NO的合成与分泌 ,使肾性高血压得以控制 ,同时减少蛋白尿排泄 ,保护肾机能。

The protection of renal function in the ACEI treatment of renal hypertension

Objective: To explore the influence of angiotensin converting enzyme inhibitiors (ACEI) on plasma endothelin (ET 1), nitric oxide (NO) and renal function in renal hypertension patients. Methods: Sixty renal hypertension patients (Group Ⅱ) were treated with ACEI (lotensin) for 10 weeks then we measured their blood pressure (BP), plasma ET 1, NO and renal functions (BUN, Scr and proteinuria) before and after the treatment. Thirty healthy persons (Group Ⅰ) acted as control. Results: The level of plasma ET 1 was higher and plasma NO was lower in Group Ⅱ than those in Group Ⅰ. After the treatment of ACEI plasma ET 1 and proteinuria were decreased (P<0.01), and NO increased in Group Ⅱ significantly (P<0.01), while BUN and Scr decreased in abnormal renal function patients (Group Ⅱ 2) (P<0.05,P<0.01). Conclusion: The Study indicates that: ACEI is effective to renal hypertension; it decreases plasma ET 1 and increases NO in the renal hypertension patients; ACEI may play an important role in protection of renal functions and prolonging the chronic renal failure.