原发性高血压患者血清Ⅰ型和Ⅲ型前胶原水平及药物干预研究

目的　测定血清 型和 型前胶原 (procollagen,PC)水平 ,评价高血压患者心肌纤维化程度 ,并分析使用抑平舒 (Cilazapril)或波依定 (Felodipine)抗高血压治疗对二者的影响。方法　 4 9例原发性高血压患者分为两组 :抑平舒治疗组 (n=2 2 )和波依定治疗组 (n=2 7) ,2 3例未经治疗的高血压患者作为实验对照组 ,2 0名同龄健康者为正常对照组 ,采用放射免疫分析法测定其血清 PC 、PC 水平 ,用超声测量其左心室解剖参数 ,计算左心室质量指数(L VMI)。结果　高血压实验对照组 L VMI、血清 PC 、PC 水平较正常对照组显著升高 (L VMI:110 .0 7± 19.31对 83.73± 15 .5 0 ,PC :12 0 .96± 2 4 .4 2对 71.6 3± 17.80 ,PC :95 .92± 9.75对 6 7.90± 9.37,P<0 .0 1)。高血压患者中未经治疗者 L VMI、血清 PCI水平显著高于经抑平舒或波依定治疗 6个月的患者 (L VMI:110 .0 7± 19.31对 96 .95± 2 1.92 ,110 .0 7± 19.31对 98.5 1± 19.2 5 ;PC :12 0 .96± 2 4 .4 2对 80 .5 1± 19.6 6 ,12 0 .96± 2 4 .4 2对93.0 5± 19.6 1,P<0 .0 1) ,血清 PCI水平抑平舒治疗组低于波依定治疗组 (80 .5 1± 19.6 6对 93.0 5± 19.6 1,P<0 .0 5 ) ,而血清 PC 水平高血压患者三组间均无差异。结论　 1.血清 PC 和 PC 浓度可以?

Serum levels of procollagen type Ⅰ/Ⅲ and effects of pharmaceutical intervention in patients with essential hypertension

Objective To evaluate the extent of myocardial fibrosis in patients with essential hypertension and the effects of cilazapril and felodipine on myocardial fibrosis. Methods 49 patients with essential hypertension were divided into two groups: cilazapril treatment group( n =22)and felodipine treatment group( n =27), 23 hypertension patients were as experimental control one, 20 healthy subjects as a normal control group. Serum PCⅠ,PCⅢ were measured by radioimmuoassay. Two dimentional echocardiography were conducted to calculate left ventricular mass index(LVMI)in all subjects. Results LVMI, serum levels of PCⅠ, PCⅢ were significant higher in experimental hypertension patients compared to the normal control one (LVMI: 110.07±19.31 vs 83.73±15.50, PCI: 120.96 ±24.42 vs 71.63±17.80, PCⅢ: 95.92±9.75 vs 67.90±9.37, P <0.01). After 6 months treatment with cilazapril or felodipine, LVMI and PCIs were markedly decreased compared to the experimental hypertension patients. (LVMI: 96.95±21.92 vs 110.07±19.31, 98.51±19.25 vs 110.07±19.31;PCI: 80.51±19.66 vs 120.96 ±24.42,93.05±19.61 vs 120.96±24.42, P <0.01). Further, PCIs were much lower in cilazapril group than those in felodipine group(80.51±19.66vs93.05±19.61, P <0.05). There were no differences in serum levels of PCⅢ among three hypertension groups. Conclusions It is suggested that serum PCⅠ and PCⅢ may be a useful marker of myocardial fibrosis in patients with hypertension. Both cilazapril and felodine can decrease myocardial matrix collagen synthesis, reversed myocardial fibrosis. Cilazapril appeared to be more effective in improving myocardial fibrosis than felodipine.