芦沙坦对轻、中度高血压病患者血小板活化和肾功能的影响

目的 :研究芦沙坦对轻、中度高血压病患者血小板活化和肾功能的影响 ,并探讨血小板活化和高血压性肾损害的关系。方法 :6 0例轻、中度高血压病患者随机分为两组 ,分别接受芦沙坦、氨氯地平治疗 3个月。治疗前后检测尿蛋白排泄率 (UAER)、血浆α颗粒膜蛋白 (GMP 14 0 )、血尿素氮 (BUN)、血肌酐 (Bcr)和肌酐清除率 (CCR)。结果 :①治疗后两组患者血压均明显下降 (P <0 .0 0 1) ,GMP 14 0和UAER均显著降低 (P <0 .0 0 1) ,BUN ,Bcr,CCR无明显变化 ;②两组患者治疗前、治疗后UAER与GMP 14 0呈显著正相关 (r分别为 0 6 9和 0 4 8) ,与血压下降无显著相关。结论 :①芦沙坦、氨氯地平能有效地控制轻、中度高血压病患者血压 ,减轻早期高血压性肾损害 ;②推测该药可能通过抑制血小板活化而对肾功能产生保护作用

Effect of losartan and amilodipine on the platelet activation and renal function in patients with mild and moderate hypertension

Objective To evaluate the effect of losartan and amilodipine on the platelet activation and renal function, and to study the relationship between the platelet activation and hypertensive renal damage in patients with mild and moderate hypertension. Methods Sixty patients with mild and moderate hypertension were divided into the losartan group and amilodipine group in a randomized and controlled method. Losartan or amilodipine was given for three months. The urinary albumin excretion rate (UAER), plasma α granule membrane protein 140 (GMP 140), BUN, Bcr and creatinine clearance rate (CCR) were measured before and after the treatment. Results ① The blood pressure, GMP 140 and UAER significantly decreased in the two groups after the treatment. ② A positive correlation was found between the level of GMP 140 and that of UAER before or after the treatment in the patients with hypertension (r=0.69, r=0.48, P<0.01), but no significant positive correlation was found between the decreased level of UAER and blood pressure after the treatment. Conclusion The blood pressure can be well controlled, and the renal function is improved after the treatment with losartan or amilodipine, of which the inhibition to the patelet activation may be responsible for the improvement of the renal function in patients with mild and moderate hypertension.