【摘要】 研究缬沙坦对慢肝、肝硬化患者肾素 -血管紧张素系统 (RAS)的影响并探讨其作用机制。 5 4例慢肝、肝硬化患者 ,随机分为治疗组和对照组。对照组给予常规保肝治疗 ,治疗组在常规治疗的基础上加用缬沙坦 80mg/日 ,疗程 1个月。采用放免法检测治疗前后血清肾素 (PRA)、血管紧张素Ⅱ (AⅡ )、醛固酮 (ALD)的变化 ;采用半定量逆转录PCR技术测定治疗组 5例慢肝患者缬沙坦治疗前后血管紧张素原mRNA、血管紧张素ⅡⅠ型受体mRNA表达的变化。结果发现经缬沙坦治疗后 ,血清PRA、AⅡ均较治疗前明显升高 ,ALD则明显降低。与对照组相比 ,治疗组治疗后血清RAS各激素水平的变化均有显著性差异 ,而肝组织血管紧张素原mRNA、血管紧张素ⅡⅠ型受体mRNA的表达较治疗前降低。研究提示缬沙坦可以有效抑制慢性肝病患者循环和肝组织局部RAS的过度激活 ,对慢肝、肝硬化患者的治疗有一定的积极作用更多还原

【Abstract】 To study the effect of valsartan on renin-angiotensin system (RAS) of chronic hepatitis and liver cirrhosis 54chronic hepatitis and liver cirrhosis patients were randomly divided into two groups: therapy group and control group. 27 cases in each group. The control group was treated with routine treatment, the therapy group, besides routine treatment, was added valsartan 80mg/day. The therapy period is 1 month. Before and after treatment, serum renin (PRA)?angiotensin Ⅱ(AⅡ)?aldosterone (ALD) were measured by radioimmunoassay. In therapy group, before and after therapy, 5 cases of chronic hepatitis patients’ liver tissue were obtained by liver biopsy, then semi-quantity RT-PCR method was used to measure the expression of liver tissue angiotensinogen mRNA?angiotensin Ⅱ type Ⅰ receptor mRNA. As a result, in therapy group, after treated with valsartan, the PRA?AⅡ were elevated remarkably (P<0.05),ALD was lower (P<0.05)?In therapy group, the patients’ PRA?AⅡ were all elevate significantly (P<0.01), the ALD was decreased (P<0.001);after treated by valsartan, the expression of liver tissue angiotensinogen mRNA?angiotensin Ⅱ type Ⅰ receptor mRNA were all lower than before (P<0.05). So valsartan can modulate the patients’ circulation and local liver tissue renin-angiotensin system, thus inhibit the overactive of the renin-angiotensin-aldosterone system in patients with chronic hepatitis and liver cirrhosis.更多还原