论文部分内容阅读
目的:比较吲达帕胺和缬沙坦治疗对高血压病患者外周血中细胞因子单核细胞趋化因子-1(MCP-1)、巨噬细胞炎性蛋白1α(MIP-1α)、可溶性P选择素(sP-selectin)、非对称二甲基精氨酸(ADMA)、血管紧张素Ⅱ(AngⅡ)和6-酮-PGF1α(6-keto-PGF1α)的影响。方法:选取我院门诊健康体检者20例和41例原发性高血压患者,将41例高血压患者随机分为吲哒啪胺组(20例)和缬沙坦组(21例),分别予吲哒啪胺(商品名钠催离)1.5mg/d和缬沙坦(商品名代文)80mg/d治疗4周,治疗前和治疗4周后抽血检测MCP-1,MIP-1α,sP-selectin,ADMA,AngⅡ和6-keto-PGF1α含量。结果:同正常血压组相比,高血压病患者外周血中MCP-1,MIP-1α,sP-selectin,ADMA浓度显著增加。吲哒啪胺组治疗前后MCP-1,MIP-1α和sP-selectin浓度无明显变化;而缬沙坦治疗4周后,MCP-1,MIP-1α和sP-selectin浓度与治疗前相比均显著下降分别为(19.16±3.11)pg/mLvs(16.08±2.67)pg/mL,P<0.05;(27.74±8.36)pg/mLvs(17.64±7.59)pg/mL,P<0.05;(2.67±3.18)pg/mLvs(6.15±2.94)pg/mL,P<0.01。吲达帕胺和缬沙坦治疗后,ADMA浓度均下降分别为(1.35±0.74)μmol/Lvs(0.98±0.56)μmol/L,P<0.05;(1.31±0.68)μmol/Lvs(0.71±0.52)μmol/L,P<0.01,而6-keto-PGF1α浓度增加,但在缬沙坦组增高更加显著分别为(61.96±20.81)pg/mLvs(96.72±25.89)pg/mL,P<0.05;(63.25±16.92)pg/mLvs(143.22±43.45)pg/mL,P<0.01。两组治疗前后AngⅡ无显著变化。结论:轻中度高血压病患者外周血中细胞因子MCP-1,MIP-1α,sP-selectin和ADMA的浓度增加;缬沙坦和吲哒啪胺具有相似的降压疗效,同时还可降低上述细胞因子水平。
Objective: To compare the effects of indapamide and valsartan on the expression of cytokines MCP-1, MIP-1α, P-selectin, ADMA, AngⅡ and 6-keto-PGF1α were measured. Methods: Totally 20 healthy subjects and 41 patients with essential hypertension were enrolled in this study. 41 patients with hypertension were randomly divided into indapamine group (n = 20) and valsartan group (n = 21) 1.5 mg / d for Indapamide and 80 mg / d for valsartan (trade name Soprano) for 4 weeks. Before and 4 weeks after treatment, blood samples were collected for determination of MCP-1, MIP-1α , sP-selectin, ADMA, AngⅡ and 6-keto-PGF1α. Results: Compared with normotensive group, the concentrations of MCP-1, MIP-1α, sP-selectin and ADMA in peripheral blood of hypertensive patients increased significantly. The concentrations of MCP-1, MIP-1α and sP-selectin did not change before and after treatment with indapamine. Compared with those before treatment, the concentrations of MCP-1, MIP-1α and sP- (19.16 ± 3.11) pg / mL vs (16.08 ± 2.67) pg / mL respectively, P <0.05; (27.74 ± 8.36) pg / mL vs ) pg / mL vs (6.15 ± 2.94) pg / mL, P <0.01. After treatment with indapamide and valsartan, the concentrations of ADMA decreased (1.35 ± 0.74) μmol / L vs 0.98 ± 0.56 μmol / L, respectively (P <0.05); (1.31 ± 0.68) μmol / L vs (61.96 ± 20.81) pg / mLvs (96.72 ± 25.89) pg / mL, respectively, P <0.05), while the concentration of 6-keto-PGF1α increased in Valsartan group (P < (63.25 ± 16.92) pg / mL vs (143.22 ± 43.45) pg / mL, P <0.01. Before and after treatment Ang Ⅱ no significant change. CONCLUSIONS: The concentrations of cytokines MCP-1, MIP-1α, sP-selectin and ADMA in peripheral blood of patients with mild to moderate hypertension are increased. Valsartan and indapamine have similar antihypertensive effect, The above cytokine levels.