替米沙坦和福辛普利对高血压左室肥厚患者血浆内皮素和一氧化氮浓度的影响

目的 探讨替米沙坦和福辛普利对高血压伴左心室肥厚(LVH)患者血中内皮素(ET)和一氧化氮(NO)浓度的影响.方法 高血压病患者118例中伴左心室肥厚(LVH) 60例(A组),随机平分两亚组,分别予24周的替米沙坦(T组)或福辛普利(F组)治疗;其余不伴LVH的 58例作为对照(B组).用放免法测定血浆ET浓度,硝酸还原酶法测定血清NO活性,彩色多普勒超声测定左室结构和功能.结果 A组治疗前血浆ET水平较B组高,而NO活性较B组低(P＜0.01);左心室重量指数(LVMI)与ET、血压呈正相关(r=0.396、0.421,P均＜0.01),与NO呈负相关(r=0.412,P＜0.01).治疗24周后,A组血浆ET、LVMI降低及血清NO升高均差异显著(P＜0.01),且F组略优于T组(P＜0.05).结论 替米沙坦和福辛普利均能有效地控制血压及调节ET/NO比率,对LVH有逆转作用;福辛普利在逆转LVH和升高血清NO方面优于替米沙坦.

Effects of telmisartan and fosinopril on the levels of plasm endothelin,serum nitric oxide in hypertensive patients with left ventricular hypertrophy

Objective To investigatethe the effects of telmisartan and fosinopril on the levels of plasm endothelin(ET),serum nitric oxide(NO) in hypertensive patients with left ventricular hypertrophy(LVH).Methods The levels of ET and NO were detected with radioimmmuneassay and colorimetric methods in hypertensive patients with LVH (60 cases,group A) and without LVH(58 cases,guoup B).The patients in group A were treated either with telmisartan (group T) or fosinopril (group F) for 24 weeks,which were not in group B.Color Doppler echocardiography was used to study left ventricular structure and function.Results The plasm ET level in group A was higher and serum NO lower signifieantly than that in group B(P<0.01).ET and blood pressure were positively correlated with left ventricular mass index (LVMI) (r=0.396, P<0.01) and negatively correlated with NO (r=0.412,P<0.01).ET and LVMI were significantly decreased and NO increased in group A 24 weeks after treatment compared with those before,especially in group F.Conclusion Telmisartan and fosinopril were all effective in reducing blood pressure,regulating the ratio of ET/NO and reversing LVH,in which fosinopril is better than telmisartan.