厄贝沙坦与非洛地平对原发性高血压纤溶系统影响的比较

目的 :通过比较厄贝沙坦和非洛地平对原发性高血压 (EH)患者纤溶系统的影响 ,探讨在改善EH纤溶障碍方面厄贝沙坦是否优于非洛地平。方法 :5 3例 1、2级EH患者随机分为厄贝沙坦组 2 8例 (厄贝沙坦15 0mg/d)和非洛地平组 2 5例 (非洛地平 5mg/d) ,共服药物 2周 ,观察治疗前后血压、血浆组织型纤溶酶原激活物 (tPA)及其抑制物 (PAI 1)含量、D 二聚体 (D D)和血管性血友病因子 (vWF)水平的变化。结果 :两组患者的基本资料差异无显著性意义 (P >0 .0 5 ) ,两组患者治疗后血压均显著性下降 (P <0 .0 1) ,但两组之间治疗前后血压相比差异无显著性意义 (P >0 .0 5 )。治疗后两组PAI 1、vWF和D D水平均显著下降 (P <0 .0 5 ) ,tPA和tPA/PAI 1比值明显升高 (P <0 .0 5 )。两组之间治疗前的tPA、PAI 1、D D和vWF含量差异均无显著意义 ,治疗后的D D和vWF水平差异也无显著性意义 ,但PAI 1含量在厄贝沙坦组减少更明显 (P <0 .0 5 ) ,tPA和tPA/PAI 1比值在厄贝沙坦组增加更显著 (P <0 .0 5 )。结论 :厄贝沙坦和非洛地平均能有效改善EH的纤溶障碍 ,但厄贝沙坦优于非洛地平

Differential effects of irbesartan and felodipine on the fibrinolytic system in essential hypertension

Objective:To assess the effect of irbesartan and felodipine on the fibrinolytic system in essential hypertension (EH).Methods:Tissue plasminogen ativator antigen(tPA) and tissue plasminogen activator inhibitor 1(PAI 1) antigen were measured in fifty three patients, before and two weeks after administration, which of them were divided into two group (twenty eight patients treated with 150 mg irbesartan once a day and twenty five patients treated with 5 mg felodipine once a day). Plasma D dimer(D D) and von Willebrand factor(vWF) levels were also measured.Results:There were no significant differences in basal characteristics between this two groups. In each hypertensive group, blood pressure was significantly reduced to a similar level after drug treatment. In the two hypertensive groups, plasma PAI 1,vWF and D D level significantly decreased, but tPA and tPA/PAI 1 ratio significantly increased after drug treatment. Between two hypertensive groups, irbesartan group had significantly lower PAI 1 antigen level, and significantly higher tPA level or tPA/PAI 1 ratio than felodipine group after drug treatment,but there were no significantly differences in vWF and D D level after drug treatment between two groups.Conclusion:Both irbesartan and felodipine improved impaired fibrinolysis in essential hypertension, but irbesartan is better than felodipine.