阿利吉仑对原发性高血压患者血一氧化氮和缓激肽的影响

目的 分析血一氧化氮(NO)、缓激肽(BK)及非优势臂坐位血压等指标在应用阿利吉仑及雷米普利前后的变化特点,探讨阿利吉仑对原发性高血压患者血NO、BK的影响及其临床意义.方法 选取轻、中度原发性高血压患者67例,经过2周的单盲安慰剂导入后,根据随机表上获得的随机号被分配到不同组别,各组均连续用药8周.试验揭盲显示:试验组50例(阿利吉仑组),给予阿利吉仑治疗,又分为三个亚组,300mg组(16例)、150mg组(17例)、75mg组(17例);对照组17例(雷米普利组),给予雷米普利5 mg治疗.采用双抗体夹心酶联免疫吸附试验测定血NO及放射免疫分析测定血BK用药前后浓度,测量患者用药前后非优势臂坐位血压.结果 阿利吉仑组用药后,NO浓度升高[300mg组、150mg组、75mg组用药前分别为(44.414±5.841)、(43.496±5.576)、(41.037±5.312)μmol/L,用药后分别为(60.381±6.756)、(56.480±6.959)、(53.766±7.276)μmol/L],非优势臂坐位血压降低,差异均有统计学意义(P<0.05),但阿利吉仑组用药前后血BK浓度比较差异无统计学意义(P>0.05).雷米普利组用药后,血NO、BK浓度较用药前均显著增加[(57.286±6.431)μmol/L比(39.935±6.388)μmol/L,(7.120±1.015)μg/L比(5.232±1.288)μg/L],非优势臂坐位血压降低,差异均有统计学意义(P<0.05).结论 阿利吉仑与雷米普利均显著增加血NO水平.雷米普利显著增加血BK水平,但阿利吉仑不影响.

The effects of aliskiren on blood nitric oxide and bradykinin in essential hypertension patients

Objective To investigate the effects of aliskiren on blood nitric oxide (NO) and bradykinin (BK) through analyzing the changes of NO, BK and non-dominant arm blood pressure before and after treatment of aliskiren and ramipril. Methods The chnical trial was conducted in 67 patients with essential hypertension. After a single-blind period of taking placebo orally once a day for 2 weeks, the patients were divided into different group in accordance with random table, and all patients were consecutively treated with drugs for 8 weeks. The trial uncovered showed that 17 patients were treated with ramipril (5 mg) in control group. Patients in trial group were given aliskiren and were assigned to three subgroups, 300 mg group (300 mg aliskiren, 16 cases), 150 mg group (150 mg aliskiren, 17 cases) and 75 mg group (75 mg aliskiren, 17 cases). The blood NO and BK before and after treatment in two groups were measured by enzyme linked immunosorbent assay and radioimmunoassay method. Non-dominant arm blood pressure was measured by calibration qualified mercury blood pressure instrument before and after treatment. Results The blood NO after treatment of aliskiren 8 weeks in trial group increased significantly than those before treatment [before treatment, the blood NO in 300 mg group, 150 mg group,75 mg group were (44.414 ±5.841 ), (43.496 ± 5.576), (41.037 ± 5.312) μ mol/L, after treatment they were(60.381 ± 6.756), (56.480 ±6.959), (53.766 ±7.276) μmol/L] (P <0.05). After treatment, non-dominant arm blood pressure decreased significantly in trial group (P < 0.05 ), but the blood BK had no significant defference before and after treatment (P >0.05). The blood NO and BK after treatment of ramipril 8 weeks in control group increased significantly than those before treatment [(57.286 ±6.431) μmol/L vs. (39.935 ±6.388)μ mol/L, (7.120 ± 1.015) μg/L vs. (5.232 ± 1.288) μg/L], and meanwhile non-dominant arm blood pressure decreased significantly (P <0.05). Conclusions Aliskiren and ramipril could increase the concentration of NO remarkably. Ramipril has strong effect in increasing the concentration of BK, but aliskiren hasn't effect on BK.