缬沙坦和氨氯地平联合应用对高血压病患者血小板活化及纤溶活性的影响

目的　探讨缬沙坦和氨氯地平联合应用对高血压病 (EH)患者血小板活化状态和纤溶活性的影响。方法　 69例EH患者随机分为缬沙坦组 ( 2 3例 )、氨氯地平组 ( 2 3例 )、缬沙坦 +氨氯地平组 ( 2 3例 )。疗程 12周。治疗前后测定血浆中血小板α 颗粒膜蛋白 (GMP 140 )、组织型纤溶酶原激活剂 (t PA)及其抑制物 (PAI 1)水平。结果　三组EH患者治疗后GMP 140含量、PAI 1活性均明显降低 (P <0 0 1) ,t PA活性显著升高 (P <0 0 1)。联合治疗组降低GMP 140和升高t PA的幅度高于缬沙坦组和氨氯地平组 (P <0 0 5 )。血浆GMP 140、PAI 1降低幅度和t PA升高幅度与血压变化无显著相关 (P >0 0 5 )。结论　缬沙坦、氨氯地平均能有效抑制血小板活化、改善纤溶活性 ,两药联合应用有一定相加作用

Effect of combined treatment by valsartan and amlodipine on platelet activation and fibrinolytic activity in hypertensive patients

Objective To evaluate the effects of valsartan and amlodipine used alone or in combination on platelet activation and fibrinolytic activity in patients with essential hypertension (EH).Methods Sixty-nine cases with EH were divided randomly into three groups:valsartan (n=23,80～160 mg/d),amlodipine (n=23,5～10 mg/d),and combined treatment (n=23, valsartan 80 mg/d +amlodipine 5 mg/d).Treatment lasted for 12 weeks.The levels of platelet alpha-granule membrane protein (GMP-140),tissue-type plasminogen activator (t-PA) and its inhibitor (PAI-1) were measured before and after treatment.Results Levels of GMP-140 and PAI-1 activity were decreased (P<0.01),but t-PA activity was increased (P<0.01) after treatment in all the three groups. Magnitude of change of GMP-140 and t-PA in the combined treatment group was higher than that either in valsartan or in amlodipine group (P<0.05).No significant correlation between the magnitude of decrease or increase of GMP-140,PAI-1 and t-PA activity and that of blood pressures (BP) was found among all the three groups(P>0.05 ).Conclusion These findings indicate that valsartan combined with amlodipine treatment has additive effect on inhibiting platelet activation and improving fibrinolytic activity in patients with EH.