Haemorheological effects of losartan and enalapril in patients with renal parenchymal disease and hypertension
Haemorheological effects of losartan and enalapril in patients with renal parenchymal disease and hypertension
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氯沙坦和依那普利对肾实质疾病和高血压患者的血液流变学影响
DOI：
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发表时间：
2000
影响因子：
2.7
通讯作者：
BI Shand
中科院分区：
文献类型：
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作者：
BI Shand
本研究的目的是比较血管紧张素 II (ang II) 拮抗剂氯沙坦和血管紧张素转换酶抑制剂 (ACEI) 依那普利对血液流变学的影响。 29 名患有肾实质疾病和高血压的患者参加了这项前瞻性、开放性、平行研究，该研究包括 14 天的清除期和随后的 120 天的治疗期。患者被随机分配接受氯沙坦 50–100mg/天 (n = 15) 或依那普利 2.5–10mg/天 (n = 14)，以实现血压控制<140/90mm hg。在清除阶段后以及治疗2、10、60和120天后测量血压、血液流变学特征和血浆纤维蛋白原浓度。使用重复测量的方差分析对数据进行分析。二十七名患者完成了这项研究。氯沙坦和依那普利治疗与相对高剪切率全血粘度显着降低（P<0.05）相关，表明血细胞变形能力增加。在服用氯沙坦的患者中，血细胞变形能力的增加并没有导致平均全血粘度的降低，因为平均血浆粘度随之显着增加（P < 0.01）。相比之下，接受依那普利治疗的患者细胞变形能力的改善导致平均全血粘度小幅且统计学上不显着的下降（P = 0.06；平均变化 = −0.15 mPa·秒）。与氯沙坦相关的血细胞变形能力增加和血浆粘度升高的机制尚不清楚。氯沙坦和依那普利对内在血细胞流变学的改善可能是阳离子转运系统变化和/或药物代谢物的保护性抗氧化特性的结果，但尚未得到证实。
The objective of this study was to compare the effects of the angiotensin II (ang II) antagonist, losartan and the angiotensin-converting enzyme inhibitor (ACEI), enalapril on haemorheology. Twenty-nine patients with renal parenchymal disease and hypertension were enrolled in the prospective, open, parallel study that involved a 14-day washout period followed by a 120-day treatment period. Patients were allocated randomly to receive either losartan 50–100 mg/day (n = 15) or enalapril 2.5–10 mg/day (n = 14) to achieve blood pressure control <140/90 mm hg. blood pressure, haemorheology profile and plasma fibrinogen concentration were measured after the washout phase and after 2, 10, 60, and 120 days of treatment. the data were analysed using anova with repeated measures. twenty-seven patients completed the study. treatment with both losartan and enalapril was associated with a significant decrease (P < 0.05) in relative high shear rate whole blood viscosity, indicating an increase in blood cell deformability. in patients taking losartan, the increase in blood cell deformability did not result in a decrease in mean whole blood viscosity due to a concomitant, significant increase in mean plasma viscosity (P < 0.01). in contrast, the improved cell deformability in patients treated with enalapril resulted in a small and statistically insignificant decrease in mean whole blood viscosity (P = 0.06; mean change = −0.15 mPa sec). The mechanism of the increase in blood cell deformability and the rise in plasma viscosity associated with losartan remain unclear. It is possible but unproven that the improvement in intrinsic blood cell rheology with losartan and enalapril may be the result of changes in cation transport systems and/or the consequence of the protective antioxidant properties of drug metabolites.
影响因子：
5.9
作者：
LETCHER, RL;CHIEN, S;LARAGH, JH
通讯作者：
LARAGH, JH