替米沙坦对高血压伴不稳定性心绞痛患者单核细胞中PPARs表达的影响

目的探讨血管紧张素Ⅱ受体拮抗剂对高血压伴不稳定性心绞痛患者单核细胞过氧化物酶体增殖物激活受体(PPARs)表达的影响。方法 170例高血压伴不稳定性心绞痛患者随机分为替米沙坦组(n=85)和氯沙坦组(n=85),治疗6 mon,应用蛋白免疫印迹法检测治疗前后外周血单核细胞PPAR-δ及PPAR-γ的表达,测定治疗前后血清基质金属蛋白酶-9(MMP-9)、高敏C-反应蛋白(hs-CRP)及白细胞介素-6(IL-6)的水平。常规方法测定空腹血糖、血脂,放免法检测肾素活性、血管紧张素Ⅱ及醛固酮水平。结果干预6 mon后,两组患者血压、MMP-9、hs-CRP及IL-6均明显下降(P<0.01);替米沙坦组患者单核细胞PPAR-δ的表达明显高于氯沙坦组(P<0.01),而PPAR-γ的表达无变化(P>0.05);与氯沙坦组比较,替米沙坦组患者血清MMP-9、hs-CRP及IL-6的水平均降低(P<0.05)。两组间空腹血糖、血脂、肾素活性、血管紧张素II及醛固酮水平差异无显著性(P>0.05)。结论替米沙坦可能通过增加高血压伴不稳定性心绞痛患者单核细胞中PPAR-δ的表达,抑制炎症介质的分泌,改善动脉粥样硬化。

The effects of telmisartan on the expression of PPARs in monocytes from patients with hypertension and unstable angina

Aim To investigate the effects of angiotensin Ⅱ receptor type 1 blockers on the expression of peroxisome proliferator-activated receptors(PPARs)in monocytes from patients with hypertension and unstable angina.Methods 170 patients with hypertension and unstable angina were randomly divided into telmisartan group(n=85)and losartan group(n=85).After 6-month treatment,PPAR-δ and PPAR-γ expressions in the monocytes were detected using Western blot,and plasma matrix metalloproteinase-9(MMP-9),high sensitive-C reactive protein(hs-CRP),interleukin-6(IL-6),fasting plasma glucose(FPG),lipids,rennin activity and angiotensin Ⅱ/aldosterone were measured.Results After 6-month intervention,the blood pressure and the levels of MMP9,hs-CRP and IL-6 were significantly reduced in both groups(all P<0.01).PPAR-δ(P<0.01)but not PPAR-γ expression level was significantly higher in telmisartan group than in losartan group.Compared with losartan group,patients in telmisartan group showed lower MMP-9,hs-CRP and IL-6 levels(all P<0.05).Additionally,the FPG,plasma lipids,rennin activity and angiotensin II/aldosterone were similar between the two groups.Conclusion Telmisartan might inhibit the inflammatory mediators and consequently ameliorate atherosclerosis through upregulating monocytes PPAR-δ in patients with hypertension and unstable angina.