氯沙坦对原发性高血压患者纤溶功能影响.docVIP

氯沙坦对原发性高血压患者纤溶功能的影响 氯沙坦对原发性高血压患者纤溶功能的影响 作者：王丽莉 作者单位：天津医科大学总医院干部保健，天津 300052 【摘要】 观察氯沙坦对原发性高血压（EH）患者纤溶功能的影响。方法 观察34例EH患者应用氯沙坦治疗4周后收缩压(SBP)、舒张压(DBP)、心率、血浆组织型纤溶酶原激活物(tPA)、内皮细胞型纤溶酶原激活物抑制剂(PAI1)水平的变化，并与30例健康人作比较。结果 治疗前EH患者血浆tPA水平明显低于对照组，而PAI1水平明显高于对照组（均P0.01）。氯沙坦治疗4周后，血压明显下降，心率无明显变化，血浆tPA水平增加，但无统计学意义，而PAI1水平明显降低，tPA/ PAI1比值升高（均P0.01）。结论 EH患者存在着内源性纤溶功能紊乱，氯沙坦可以改善EH患者的纤溶功能。 【关键词】 氯沙坦 原发性高血压 纤溶功能 Effects of losartan therapy on fibrinolysis in essential hypertension patients WANG Lili, XIAO Guanghui，DU Weijing, WANG Peixian. Department of Geriatrics, General Hospital of Tianjin Medical University, Tianjin 300052 , China Abstract：Objective To investigate the effects of losartan on fibrinolysis in 34 essential hypertension patients. Methods Thirtyfour patients with essential hypertension were given losartan for 4 weeks. Systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), concentration of plasminogen activator inhibitor (PAI1) and tissuetype plasminogen activator (tPA) were measured before and after losartan treatment. Thirty healthy persons were taken as control group. Results Before treatment, plasma tPA level was lower and PAI1 level was higher in hypertension group than in control group (P0.01). After losartan treatment, the SBP and DBP were both significantly decreased (P0.01) in hypertension group, while the HR and the tPA level did not change. The PAI1 level was decreased and the ratio of tPA/ PAI1 was increased significantly (both P0.01). Conclusions There is endogenous fibrinolysis disturbance in essential hypertension patients and losartan therapy can improve the fibrinolytic activity. Key words： Losartan； Essential hypertension； Fibrinolysis 原发性高血压（essential hypertension, EH）是临床常见病、多发病，近年有研究表明，EH患者存在着内源性纤溶功能紊乱[1，2]，这增加了其发生血栓栓塞性心脑血管事件的危险性。本文旨在了解血管紧张素Ⅱ1型受体（AT1）拮抗剂氯沙坦对EH患者血浆纤溶指标组织型纤溶酶原激活剂（tPA）及其抑制物内皮细胞型纤溶酶原激活物抑制剂（PAI1）水平的影响，并探讨其作用机制。 1 对象和方法 1.1