论文部分内容阅读
目的 了解血管紧张素Ⅱ受体拮抗剂 (ATRA)和转换酶抑制剂 (ACEI)对慢性肾衰 (CRF)高血压患者血浆心钠素 (ANF)和肾素 血管紧张素系统 (RAS)的影响。方法 受试者口服氯沙坦 (Los组 )或福辛普利 (Fos组 )连续 12周 ,于治疗前和治疗后第 4、8及 12周测定坐位舒张压 (SiDBP)、血清尿素氮 (BUN)、血清肌酐 (SCr)、ANF、血管紧张素Ⅰ (AⅠ )和血管紧张素Ⅱ (AⅡ )。用SPSS 7.0软件作统计分析。结果 经 12周治疗 ,两组患者SiDBP均降至目标值。Fos组 :与治疗前比较 ,AⅡ下降 ,ANF和Scr升高 (P <0 .0 1)。Los组 :AⅡ明显升高 (P<0 .0 1) ,ANF在短暂升高后降至治疗前水平 ,Scr无变化。结论 ACEI可能对CRF高血压患者肾内灌注压有影响 ,ANF动态改变可作为肾内灌注压变化的指标之一。ATRA对肾内灌注压影响小于ACEI。
Objective To investigate the effects of angiotensin Ⅱ receptor antagonist (ATRA) and converting enzyme inhibitor (ACEI) on plasma atrial natriuretic peptide (ANF) and renin angiotensin system (RAS) in patients with chronic renal failure (CRF) . METHODS: Losartan and fosinopril were administered orally for 12 consecutive weeks. Before and after 4, 8 and 12 weeks of treatment, the patients were assessed for sitting-point diastolic blood pressure (SiDBP), serum urea nitrogen BUN), serum creatinine (SCr), ANF, angiotensin Ⅰ (AⅠ) and angiotensin Ⅱ (AⅡ). SPSS 7.0 software for statistical analysis. Results After 12 weeks of treatment, SiDBP in both groups dropped to their target values. Fos group: compared with before treatment, AⅡ decreased, ANF and Scr increased (P <0.01). Los group: A Ⅱ was significantly increased (P <0.01), ANF decreased to a pre-treatment level after a brief increase, while Scr remained unchanged. Conclusions ACEI may have an impact on intrarenal perfusion pressure in CRF hypertensive patients. Dynamic changes of ANF may be used as one of the indicators of intrarenal perfusion pressure changes. ATRA on renal perfusion pressure less than ACEI.